Articulatable surgical instrument

ABSTRACT

A surgical instrument that includes a surgical end effector that is articulatable relative to a proximal shaft segment of the surgical instrument. The surgical end effector is attached to the proximal shaft segment by an articulation joint that comprises a plurality of movably interconnected links that interface with a centrally disposed drive member to apply articulation motions thereto and which serve to provide improved lateral stability to the articulation joint.

CROSS-REFERENCE TO RELATED APPLICATION

This non-provisional application claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application Serial No. 62/955,299,entitled DEVICES AND SYSTEMS FOR ELECTROSURGERY, filed Dec. 30, 2019,the disclosure of which is incorporated by reference herein in itsentirety.

BACKGROUND

The present invention relates to surgical instruments designed to treattissue, including but not limited to surgical instruments that areconfigured to cut and fasten tissue. The surgical instruments mayinclude electrosurgical instruments powered by generators to effecttissue dissecting, cutting, and/or coagulation during surgicalprocedures. The surgical instruments may include instruments that areconfigured to cut and staple tissue using surgical staples and/orfasteners. The surgical instruments may be configured for use in opensurgical procedures, but have applications in other types of surgery,such as laparoscopic, endoscopic, and robotic-assisted procedures andmay include end effectors that are articulatable relative to a shaftportion of the instrument to facilitate precise positioning within apatient.

SUMMARY

In various embodiments, a surgical instrument comprising a surgical endeffector that comprises an end effector frame assembly is disclosed. Aproximal shaft segment defines a shaft axis and is attached to the endeffector frame assembly by an articulation system to facilitatearticulation of the end effector frame assembly relative to the proximalshaft segment about an articulation axis that is transverse to the shaftaxis. The articulation system comprises a first link that comprises afirst link proximal end that is pivotally coupled to the proximal shaftsegment. The first link further comprises a first link distal end. Thearticulation system further comprises a second link that comprises asecond link proximal end that is pivotally coupled to the first linkdistal end. The second link further comprises a second link distal endthat is pivotally coupled to the end effector frame assembly. Thearticulation system further comprises an axially movable articulationactuator that operably interfaces with the first link at a locationbetween the first link proximal end and the first link distal end toapply articulation motions thereto.

In various embodiments, a surgical instrument comprising a surgical endeffector that comprises an end effector frame assembly is disclosed. Afirst jaw is pivotally coupled to the end effector frame assembly. Asecond jaw is pivotally coupled to the first jaw. The first jaw and thesecond jaw are pivotally movable between an open position and a closedposition upon application of axial control motions to the second jaw.The surgical instrument further comprises a proximal shaft segment thatdefines a shaft axis. The proximal shaft segment is attached to the endeffector frame assembly by an articulation system to facilitatearticulation of the end effector frame assembly relative to the proximalshaft segment about an articulation axis that is transverse to the shaftaxis. The articulation system comprises a first link that comprises afirst link proximal end that is pivotally coupled to the proximal shaftsegment. The first link further comprises a first link distal end. Thearticulation system further comprises a second link that comprises asecond link proximal end that is pivotally coupled to the first linkdistal end. The second link further comprises a second link distal endthat is pivotally coupled to the end effector frame assembly. Thearticulation system further comprises an axially movable articulationactuator that operably interfaces with the first link at a locationbetween the first link proximal end and the first link distal end toapply articulation motions thereto. The surgical instrument furthercomprises a drive member that extends between the right proximal linkand the left proximal link. The drive member is coupled to the secondjaw to apply the axial control motions thereto.

BRIEF DESCRIPTION OF THE DRAWINGS

The novel features of the various aspects are set forth withparticularity in the appended claims. The described aspects, however,both as to organization and methods of operation, may be best understoodby reference to the following description, taken in conjunction with theaccompanying drawings in which:

FIG. 1 illustrates an example of a generator for use with a surgicalsystem, in accordance with at least one aspect of the presentdisclosure;

FIG. 2 illustrates one form of a surgical system comprising a generatorand an electrosurgical instrument usable therewith, in accordance withat least one aspect of the present disclosure;

FIG. 3 illustrates a schematic diagram of a surgical instrument or tool,in accordance with at least one aspect of the present disclosure;

FIG. 4 is a side elevational view of a portion of a surgical instrumentin an unarticulated position, in accordance with at least one aspect ofthe present disclosure;

FIG. 5 is a perspective view of a portion of an articulation joint ofthe surgical instrument of FIG. 4 articulated in a first direction;

FIG. 6 is another perspective view of the articulation joint of FIG. 5in an unarticulated position;

FIG. 7 is a side elevational view of the articulation joint of FIG. 6;

FIG. 8 is an end elevational view of the articulation joint of FIG. 7;

FIG. 9 is a top view of the articulation joint of FIG. 7;

FIG. 10 is a side elevational view of the articulation joint of thesurgical instrument of FIG. 4 articulated in a first direction;

FIG. 11 is an end elevational view of the articulation joint of FIG. 10;

FIG. 12 is a top view of the articulation joint of FIG. 10;

FIG. 13 is a side elevational view of the articulation joint of thesurgical instrument of FIG. 4 articulated in a second direction;

FIG. 14 is an end elevational view of the articulation joint of FIG. 13;

FIG. 15 is a top view of the articulation joint of FIG. 13;

FIG. 16 is a perspective view of a portion of an axial drive systemembodiment, in accordance with at least one aspect of the presentdisclosure;

FIG. 17 is another perspective view of the articulation joint of thesurgical instrument of FIG. 4;

FIG. 18 is another perspective view of the articulation joint of FIG.17;

FIG. 19 is another perspective view of the articulation joint of FIG. 17in an unarticulated position;

FIG. 20 is a bottom perspective view of the articulation joint of FIG. 4articulated in a second direction;

FIG. 21 is a partial cross-sectional view of the articulation joint ofFIG. 4 articulated in a first direction;

FIG. 22 is a cross-sectional side view of a portion of the surgicalinstrument of FIG. 4 with jaws thereof in a closed position;

FIG. 23 is a cross-sectional perspective view of the portion of thesurgical instrument of FIG. 22;

FIG. 24 is an end perspective view of the articulation joint of thesurgical instrument of FIG. 4 with the articulation joint articulated ina second direction;

FIG. 25 is a side elevational view of a portion of the surgicalinstrument of FIG. 4 with portions thereof shown in phantom;

FIG. 26 is a cross-sectional perspective view of the surgical instrumentof FIG. 25 with jaws thereof in a closed position;

FIG. 27 is another perspective view of the surgical instrument of FIG.26 with portions thereof shown in phantom;

FIG. 28 is a partial cross-sectional perspective view of a proximalshaft segment embodiment, in accordance with at least one aspect of thepresent disclosure;

FIG. 29 is a cross-sectional end view of the proximal shaft segment ofFIG. 28;

FIG. 30 is a top view of a portion of a rotary drive shaft, an actuationyoke assembly, and a threaded insert embodiment with portions of therotary drive shaft shown in phantom, in accordance with at least oneaspect of the present disclosure;

FIG. 31 is a side elevational view of the rotary drive shaft, actuationyoke assembly and threaded insert of FIG. 30;

FIG. 32 is a side elevational view of a portion of another rotary driveshaft, another actuation yoke assembly, and another threaded insertembodiment, in accordance with at least one aspect of the presentdisclosure;

FIG. 33 is a perspective view of the rotary drive shaft, actuation yokeassembly, and threaded insert of FIG. 32;

FIG. 34 is a top view of a portion of a distal frame member and aproximal housing member of a surgical instrument, in accordance with atleast one aspect of the present disclosure;

FIG. 35 is a partial perspective view of a spring clip used to supportthe proximal housing member on the distal frame member of FIG. 34;

FIG. 36 is a cross-sectional end view of the distal frame member andproximal housing member of FIG. 34;

FIG. 37 is a side elevational view of a portion of the distal framemember and proximal housing member of FIG. 34;

FIG. 38 is a partial cross-sectional perspective view of a portion ofanother surgical instrument, in accordance with at least one aspect ofthe present disclosure;

FIG. 39 is a cross-sectional side view of a portion of the surgicalinstrument of FIG. 38;

FIG. 40 is a top view of a portion of another articulation jointembodiment in an unarticulated position, in accordance with at least oneaspect of the present disclosure;

FIG. 41 is a partial cross-sectional side view of the articulation jointof FIG. 40 articulated in a first direction;

FIG. 42 is another partial cross-sectional side view of the articulationjoint of FIG. 40 articulated in a second direction;

FIG. 43 is another partial cross-sectional side view of the articulationjoint of FIG. 40 articulated in a first direction;

FIG. 44 is another partial cross-sectional side view of the articulationjoint of FIG. 40 articulated in a second direction;

FIG. 45 is a partial perspective view of a portion of anotherarticulation joint embodiment, in accordance with at least one aspect ofthe present disclosure;

FIG. 46 is a side elevational view of the articulation joint of FIG. 45in an unarticulated position;

FIG. 47 is a side view of a portion of another surgical instrument witha surgical end effector thereof in an unarticulated position and jawsthereof in a closed position with portions thereof shown in phantom, inaccordance with at least one aspect of the present disclosure;

FIG. 48 is a partial perspective view of a portion of the surgicalinstrument of FIG. 47 with some elements thereof shown in phantom;

FIG. 49 is a cross-sectional side view of a portion of the surgicalinstrument of FIG. 47 with the jaws thereof in an open position;

FIG. 50 is a partial cross-sectional view of another surgical instrumentwith the jaws thereof in an open position, in accordance with at leastone aspect of the present disclosure;

FIG. 51 is another partial cross-sectional view of the surgicalinstrument of FIG. 50 with the jaws thereof in a closed position;

FIG. 52 is a perspective view of a portion of another articulatablesurgical instrument with a surgical end effector thereof in anarticulated position and jaws of the surgical end effector in an openposition, in accordance with at least one aspect of the presentdisclosure;

FIG. 53 is a perspective view of a portion of the surgical instrument ofFIG. 52 with the surgical end effector thereof in an unarticulatedposition and the jaws thereof in a closed position;

FIG. 54 is an exploded perspective assembly view of a portion of thesurgical instrument of FIG. 52;

FIG. 55 is an exploded perspective assembly view of a portion of anothersurgical instrument, in accordance with at least one aspect of thepresent disclosure;

FIG. 56 is a side elevational view of a portion of another surgicalinstrument with a surgical end effector thereof in an unarticulatedposition and jaws of the surgical end effector in a partially closedposition, in accordance with at least one aspect of the presentdisclosure;

FIG. 57 is a partial side elevational view of a portion of anarticulation joint of the surgical instrument of FIG. 56 articulated ina first direction;

FIG. 58 is another partial side elevational view of the articulationjoint of FIG. 56 articulated in a second direction;

FIG. 59 is a partial cross-sectional side view of a portion of thesurgical instrument of FIG. 56;

FIG. 60 is a partial perspective view of a portion of the surgicalinstrument of FIG. 56;

FIG. 61 is a cross-sectional side view of a portion of the surgicalinstrument of FIG. 56;

FIG. 62 is a partial perspective view of a portion of the surgicalinstrument of FIG. 56;

FIG. 63 is a cross-sectional side elevational view of the proximal shaftsegment of FIG. 56 with an articulation joint thereof in anunarticulated position;

FIG. 64 is another cross-sectional side elevational view of the proximalshaft segment of FIG. 56 with the articulation joint thereof articulatedin a first direction;

FIG. 65 is another cross-sectional side elevational view of the proximalshaft segment of FIG. 56 articulated in a second direction;

FIG. 66 is a partial perspective view of a distal frame member and aflexible circuit arrangement of the surgical instrument of FIG. 56;

FIG. 67 is another partial perspective view of the distal frame memberand flexible circuit arrangement of FIG. 66;

FIG. 68 is a cross-sectional view of a portion of a first jawembodiment, in accordance with at least one aspect of the presentdisclosure;

FIG. 69 is a cross-sectional view of a portion of a second jawembodiment, in accordance with at least one aspect of the presentdisclosure;

FIG. 70 is a cross-sectional end view of portions of a first jaw and asecond jaw in alignment in a closed position, in accordance with atleast one aspect of the present disclosure;

FIG. 71 is another cross-sectional end view of the first jaw and secondjaw of FIG. 70 out of alignment while closing onto tissue;

FIG. 72 is a diagrammatic depiction of a first jaw and a second jaw in aclosed position, in accordance with at least one aspect of the presentdisclosure;

FIG. 73 is a cross-sectional end view of portions of the first jaw andsecond jaw of FIG. 72 out of alignment during closing;

FIG. 74 is a cross-sectional end view of portions of the first jaw andthe second jaw of FIG. 72 in alignment in a closed position;

FIG. 75 is a graphical comparison between a jaw clamping force requiredto close a first jaw and a second jaw and an amount of jaw biasing forcerequired to move the first and second jaws into alignment with eachother as the first and second jaws move from an open position to a fullyclosed position, in accordance with at least one aspect of the presentdisclosure;

FIG. 76 is a partial cross-sectional view of a portion of a first jawand a corresponding portion of a second jaw when the first jaw andsecond jaw are in a closed position, in accordance with at least oneaspect of the present disclosure;

FIG. 77 is a top view of another first jaw, in accordance with at leastone aspect of the present disclosure;

FIG. 78 is a top view of another first jaw, in accordance with at leastone aspect of the present disclosure;

FIG. 79 is a diagrammatical side view of a surgical end effectorembodiment with jaws thereof in an open position, in accordance with atleast one aspect of the present disclosure;

FIG. 80 is a cross-sectional end view of the surgical end effector ofFIG. 79 taken along line A-A in FIG. 79;

FIG. 81 is another cross-sectional end view of the surgical effector ofFIG. 79 taken along line B-B in FIG. 79;

FIG. 82 is a side elevational view of another surgical end effectorembodiment with jaws thereof in a closed position, in accordance with atleast one aspect of the present disclosure;

FIG. 83 is a side elevational view of another surgical end effectorembodiment with jaws thereof in a closed position, in accordance with atleast one aspect of the present disclosure;

FIG. 84 is a side elevational view of the surgical end effector of FIG.83 illustrating the jaws thereof in a fully closed position;

FIG. 85 is a partial perspective view of a portion of a surgicalinstrument, in accordance with at least one aspect of the presentdisclosure;

FIG. 86 is a side elevational view of a portion of the surgicalinstrument of FIG. 85;

FIG. 87 is a finite element analysis of an articulation joint of thesurgical instrument of FIG. 85 articulated in a first direction;

FIG. 88 is another finite element analysis of the articulation joint ofthe surgical instrument of FIG. 85 articulated in a second direction;

FIG. 89 is a partial view of another surgical instrument with a surgicalend effector in an unarticulated position, in accordance with at leastone aspect of the present disclosure;

FIG. 90 is another partial view of the surgical instrument of FIG. 89with the surgical end effector thereof in an articulated position;

FIG. 91 is a partial view of another surgical instrument with a surgicalend effector in an unarticulated position, in accordance with at leastone aspect of the present disclosure;

FIG. 92 is a partial view of another surgical instrument with a surgicalend effector in an unarticulated position, in accordance with at leastone aspect of the present disclosure;

FIG. 93 is a partial view of another surgical instrument with a surgicalend effector in an unarticulated position, in accordance with at leastone aspect of the present disclosure; and

FIG. 94 is a partial view of another surgical instrument with a surgicalend effector in an unarticulated position, in accordance with at leastone aspect of the present disclosure.

DETAILED DESCRIPTION

Applicant of the present application owns the following U.S. PatentApplications that were filed on even date herewith, the disclosure ofeach of which is herein incorporated by reference in its entirety:

-   Attorney Docket No. END9234USNP1/190717-1M, entitled METHOD FOR AN    ELECTROSURGICAL PROCEDURE;-   Attorney Docket No. END9234USNP3/190717-3, entitled SURGICAL    INSTRUMENT WITH JAW ALIGNMENT FEATURES;-   Attorney Docket No. END9234USNP4/190717-4, entitled SURGICAL    INSTRUMENT WITH ROTATABLE AND ARTICULATABLE SURGICAL END EFFECTOR;-   Attorney Docket No. END9234USNP5/190717-5, entitled ELECTROSURGICAL    INSTRUMENT WITH ASYNCHRONOUS ENERGIZING ELECTRODES;-   Attorney Docket No. END9234USNP6/190717-6, entitled ELECTROSURGICAL    INSTRUMENT WITH ELECTRODES BIASING SUPPORT;-   Attorney Docket No. END9234USNP7/190717-7, entitled ELECTROSURGICAL    INSTRUMENT WITH FLEXIBLE WIRING ASSEMBLIES;-   Attorney Docket No. END9234USNP8/190717-8, entitled ELECTROSURGICAL    INSTRUMENT WITH VARIABLE CONTROL MECHANISMS;-   Attorney Docket No. END9234USNP9/190717-9, entitled ELECTROSURGICAL    SYSTEMS WITH INTEGRATED AND EXTERNAL POWER SOURCES;-   Attorney Docket No. END9234USNP10/190717-10, entitled    ELECTROSURGICAL INSTRUMENTS WITH ELECTRODES HAVING ENERGY FOCUSING    FEATURES;-   Attorney Docket No. END9234USNP11/190717-11, entitled    ELECTROSURGICAL INSTRUMENTS WITH ELECTRODES HAVING VARIABLE ENERGY    DENSITIES;-   Attorney Docket No. END9234USNP12/190717-12, entitled    ELECTROSURGICAL INSTRUMENT WITH MONOPOLAR AND BIPOLAR ENERGY    CAPABILITIES;-   Attorney Docket No. END9234USNP13/190717-13, entitled    ELECTROSURGICAL END EFFECTORS WITH THERMALLY INSULATIVE AND    THERMALLY CONDUCTIVE PORTIONS;-   Attorney Docket No. END9234USNP14/190717-14, entitled    ELECTROSURGICAL INSTRUMENT WITH ELECTRODES OPERABLE IN BIPOLAR AND    MONOPOLAR MODES;-   Attorney Docket No. END9234USNP15/190717-15, entitled    ELECTROSURGICAL INSTRUMENT FOR DELIVERING BLENDED ENERGY MODALITIES    TO TISSUE;-   Attorney Docket No. END9234USNP16/190717-16, entitled CONTROL    PROGRAM ADAPTATION BASED ON DEVICE STATUS AND USER INPUT;-   Attorney Docket No. END9234USNP17/190717-17, entitled CONTROL    PROGRAM FOR MODULAR COMBINATION ENERGY DEVICE; and-   Attorney Docket No. END9234USNP18/190717-18, entitled SURGICAL    SYSTEM COMMUNICATION PATHWAYS.

Applicant of the present application owns the following U.S. ProvisionalPatent Applications that were filed on Dec. 30, 2019, the disclosure ofeach of which is herein incorporated by reference in its entirety:

-   U.S. Provisional Patent Application Ser. No. 62/955,294, entitled    USER INTERFACE FOR SURGICAL INSTRUMENT WITH COMBINATION ENERGY    MODALITY END-EFFECTOR;-   U.S. Provisional Patent Application Ser. No. 62/955,292, entitled    COMBINATION ENERGY MODALITY END-EFFECTOR; and-   U.S. Provisional Patent Application Ser. No. 62/955,306, entitled    SURGICAL INSTRUMENT SYSTEMS.

Applicant of the present application owns the following U.S. PatentApplications, the disclosure of each of which is herein incorporated byreference in its entirety:

-   U.S. patent application Ser. No. 16/209,395, titled METHOD OF HUB    COMMUNICATION, now U.S. Patent Application Publication No.    2019/0201136;-   U.S. patent application Ser. No. 16/209,403, titled METHOD OF CLOUD    BASED DATA ANALYTICS FOR USE WITH THE HUB, now U.S. Patent    Application Publication No. 2019/0206569;-   U.S. patent application Ser. No. 16/209,407, titled METHOD OF    ROBOTIC HUB COMMUNICATION, DETECTION, AND CONTROL, now U.S. Patent    Application Publication No. 2019/0201137;-   U.S. patent application Ser. No. 16/209,416, titled METHOD OF HUB    COMMUNICATION, PROCESSING, DISPLAY, AND CLOUD ANALYTICS, now U.S.    Patent Application Publication No. 2019/0206562;-   U.S. patent application Ser. No. 16/209,423, titled METHOD OF    COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY    DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS, now U.S.    Patent Application Publication No. 2019/0200981;-   U.S. patent application Ser. No. 16/209,427, titled METHOD OF USING    REINFORCED FLEXIBLE CIRCUITS WITH MULTIPLE SENSORS TO OPTIMIZE    PERFORMANCE OF RADIO FREQUENCY DEVICES, now U.S. Patent Application    Publication No. 2019/0208641;-   U.S. patent application Ser. No. 16/209,433, titled METHOD OF    SENSING PARTICULATE FROM SMOKE EVACUATED FROM A PATIENT, ADJUSTING    THE PUMP SPEED BASED ON THE SENSED INFORMATION, AND COMMUNICATING    THE FUNCTIONAL PARAMETERS OF THE SYSTEM TO THE HUB, now U.S. Patent    Application Publication No. 2019/0201594;-   U.S. patent application Ser. No. 16/209,447, titled METHOD FOR SMOKE    EVACUATION FOR SURGICAL HUB, now U.S. Patent Application Publication    No. 2019/0201045;-   U.S. patent application Ser. No. 16/209,453, titled METHOD FOR    CONTROLLING SMART ENERGY DEVICES, now U.S. Patent Application    Publication No. 2019/0201046;-   U.S. patent application Ser. No. 16/209,458, titled METHOD FOR SMART    ENERGY DEVICE INFRASTRUCTURE, now U.S. Patent Application    Publication No. 2019/0201047;-   U.S. patent application Ser. No. 16/209,465, titled METHOD FOR    ADAPTIVE CONTROL SCHEMES FOR SURGICAL NETWORK CONTROL AND    INTERACTION, now U.S. Patent Application Publication No.    2019/0206563;-   U.S. patent application Ser. No. 16/209,478, titled METHOD FOR    SITUATIONAL AWARENESS FOR SURGICAL NETWORK OR SURGICAL NETWORK    CONNECTED DEVICE CAPABLE OF ADJUSTING FUNCTION BASED ON A SENSED    SITUATION OR USAGE, now U.S. Patent Application Publication No.    2019/0104919;-   U.S. patent application Ser. No. 16/209,490, titled METHOD FOR    FACILITY DATA COLLECTION AND INTERPRETATION, now U.S. Patent    Application Publication No. 2019/0206564; and-   U.S. patent application Ser. No. 16/209,491, titled METHOD FOR    CIRCULAR STAPLER CONTROL ALGORITHM ADJUSTMENT BASED ON SITUATIONAL    AWARENESS, now U.S. Patent Application Publication No. 2019/0200998.-   U.S. patent application Ser. No. 16/562,123, titled METHOD FOR    CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH    MULTIPLE DEVICES;-   U.S. patent application Ser. No. 16/562,135, titled METHOD FOR    CONTROLLING AN ENERGY MODULE OUTPUT;-   U.S. patent application Ser. No. 16/562,144, titled METHOD FOR    CONTROLLING A MODULAR ENERGY SYSTEM USER INTERFACE; and-   U.S. patent application Ser. No. 16/562,125, titled METHOD FOR    COMMUNICATING BETWEEN MODULES AND DEVICES IN A MODULAR SURGICAL    SYSTEM.

Before explaining various aspects of an electrosurgical system indetail, it should be noted that the illustrative examples are notlimited in application or use to the details of construction andarrangement of parts illustrated in the accompanying drawings anddescription. The illustrative examples may be implemented orincorporated in other aspects, variations, and modifications, and may bepracticed or carried out in various ways. Further, unless otherwiseindicated, the terms and expressions employed herein have been chosenfor the purpose of describing the illustrative examples for theconvenience of the reader and are not for the purpose of limitationthereof. Also, it will be appreciated that one or more of thefollowing-described aspects, expressions of aspects, and/or examples,can be combined with any one or more of the other following-describedaspects, expressions of aspects, and/or examples.

Various aspects are directed to electrosurgical systems that includeelectrosurgical instruments powered by generators to effect tissuedissecting, cutting, and/or coagulation during surgical procedures. Theelectrosurgical instruments may be configured for use in open surgicalprocedures, but has applications in other types of surgery, such aslaparoscopic, endoscopic, and robotic-assisted procedures.

As described below in greater detail, an electrosurgical instrumentgenerally includes a shaft having a distally-mounted end effector (e.g.,one or more electrodes). The end effector can be positioned against thetissue such that electrical current is introduced into the tissue.Electrosurgical instruments can be configured for bipolar or monopolaroperation. During bipolar operation, current is introduced into andreturned from the tissue by active and return electrodes, respectively,of the end effector. During monopolar operation, current is introducedinto the tissue by an active electrode of the end effector and returnedthrough a return electrode (e.g., a grounding pad) separately located ona patient's body. Heat generated by the current flowing through thetissue may form hemostatic seals within the tissue and/or betweentissues and thus may be particularly useful for sealing blood vessels,for example.

FIG. 1 illustrates an example of a generator 900 configured to delivermultiple energy modalities to a surgical instrument. The generator 900provides RF and/or ultrasonic signals for delivering energy to asurgical instrument. The generator 900 comprises at least one generatoroutput that can deliver multiple energy modalities (e.g., ultrasonic,bipolar or monopolar RF, irreversible and/or reversible electroporation,and/or microwave energy, among others) through a single port, and thesesignals can be delivered separately or simultaneously to an end effectorto treat tissue. The generator 900 comprises a processor 902 coupled toa waveform generator 904. The processor 902 and waveform generator 904are configured to generate a variety of signal waveforms based oninformation stored in a memory coupled to the processor 902, not shownfor clarity of disclosure. The digital information associated with awaveform is provided to the waveform generator 904 which includes one ormore DAC circuits to convert the digital input into an analog output.The analog output is fed to an amplifier 906 for signal conditioning andamplification. The conditioned and amplified output of the amplifier 906is coupled to a power transformer 908. The signals are coupled acrossthe power transformer 908 to the secondary side, which is in the patientisolation side. A first signal of a first energy modality is provided tothe surgical instrument between the terminals labeled ENERGY₁ andRETURN. A second signal of a second energy modality is coupled across acapacitor 910 and is provided to the surgical instrument between theterminals labeled ENERGY₂ and RETURN. It will be appreciated that morethan two energy modalities may be output and thus the subscript “n” maybe used to designate that up to n ENERGY_(n) terminals may be provided,where n is a positive integer greater than 1. It also will beappreciated that up to “n” return paths RETURN_(n) may be providedwithout departing from the scope of the present disclosure.

A first voltage sensing circuit 912 is coupled across the terminalslabeled ENERGY₁ and the RETURN path to measure the output voltagetherebetween. A second voltage sensing circuit 924 is coupled across theterminals labeled ENERGY₂ and the RETURN path to measure the outputvoltage therebetween. A current sensing circuit 914 is disposed inseries with the RETURN leg of the secondary side of the powertransformer 908 as shown to measure the output current for either energymodality. If different return paths are provided for each energymodality, then a separate current sensing circuit should be provided ineach return leg. The outputs of the first and second voltage sensingcircuits 912, 924 are provided to respective isolation transformers 928,922 and the output of the current sensing circuit 914 is provided toanother isolation transformer 916. The outputs of the isolationtransformers 916, 928, 922 on the primary side of the power transformer908 (non-patient isolated side) are provided to a one or more ADCcircuit 926. The digitized output of the ADC circuit 926 is provided tothe processor 902 for further processing and computation. The outputvoltages and output current feedback information can be employed toadjust the output voltage and current provided to the surgicalinstrument and to compute output impedance, among other parameters.Input/output communications between the processor 902 and patientisolated circuits is provided through an interface circuit 920. Sensorsalso may be in electrical communication with the processor 902 by way ofthe interface circuit 920.

In one aspect, the impedance may be determined by the processor 902 bydividing the output of either the first voltage sensing circuit 912coupled across the terminals labeled ENERGY₁/RETURN or the secondvoltage sensing circuit 924 coupled across the terminals labeledENERGY₂/RETURN by the output of the current sensing circuit 914 disposedin series with the RETURN leg of the secondary side of the powertransformer 908. The outputs of the first and second voltage sensingcircuits 912, 924 are provided to separate isolations transformers 928,922 and the output of the current sensing circuit 914 is provided toanother isolation transformer 916. The digitized voltage and currentsensing measurements from the ADC circuit 926 are provided the processor902 for computing impedance. As an example, the first energy modalityENERGY₁ may be RF monopolar energy and the second energy modalityENERGY₂ may be RF bipolar energy. Nevertheless, in addition to bipolarand monopolar RF energy modalities, other energy modalities includeultrasonic energy, irreversible and/or reversible electroporation and/ormicrowave energy, among others. Also, although the example illustratedin FIG. 1 shows a single return path RETURN may be provided for two ormore energy modalities, in other aspects, multiple return pathsRETURN_(n) may be provided for each energy modality ENERGY_(n).

As shown in FIG. 1, the generator 900 comprising at least one outputport can include a power transformer 908 with a single output and withmultiple taps to provide power in the form of one or more energymodalities, such as ultrasonic, bipolar or monopolar RF, irreversibleand/or reversible electroporation, and/or microwave energy, amongothers, for example, to the end effector depending on the type oftreatment of tissue being performed. For example, the generator 900 candeliver energy with higher voltage and lower current to drive anultrasonic transducer, with lower voltage and higher current to drive RFelectrodes for sealing tissue, or with a coagulation waveform for spotcoagulation using either monopolar or bipolar RF electrosurgicalelectrodes. The output waveform from the generator 900 can be steered,switched, or filtered to provide the frequency to the end effector ofthe surgical instrument. In one example, a connection of RF bipolarelectrodes to the generator 900 output would be preferably locatedbetween the output labeled ENERGY₂ and RETURN. In the case of monopolaroutput, the preferred connections would be active electrode (e.g.,pencil or other probe) to the ENERGY₂ output and a suitable return padconnected to the RETURN output.

Additional details are disclosed in U.S. Patent Application PublicationNo. 2017/0086914, titled TECHNIQUES FOR OPERATING GENERATOR FORDIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICALINSTRUMENTS, which published on Mar. 30, 2017, which is hereinincorporated by reference in its entirety.

FIG. 2 illustrates one form of a surgical system 1000 comprising agenerator 1100 and various surgical instruments 1104, 1106, 1108 usabletherewith, where the surgical instrument 1104 is an ultrasonic surgicalinstrument, the surgical instrument 1106 is an RF electrosurgicalinstrument, and the multifunction surgical instrument 1108 is acombination ultrasonic/RF electrosurgical instrument. The generator 1100is configurable for use with a variety of surgical instruments.According to various forms, the generator 1100 may be configurable foruse with different surgical instruments of different types including,for example, ultrasonic surgical instruments 1104, RF electrosurgicalinstruments 1106, and multifunction surgical instruments 1108 thatintegrate RF and ultrasonic energies delivered simultaneously from thegenerator 1100. Although in the form of FIG. 2 the generator 1100 isshown separate from the surgical instruments 1104, 1106, 1108 in oneform, the generator 1100 may be formed integrally with any of thesurgical instruments 1104, 1106, 1108 to form a unitary surgical system.The generator 1100 comprises an input device 1110 located on a frontpanel of the generator 1100 console. The input device 1110 may compriseany suitable device that generates signals suitable for programming theoperation of the generator 1100. The generator 1100 may be configuredfor wired or wireless communication.

The generator 1100 is configured to drive multiple surgical instruments1104, 1106, 1108. The first surgical instrument is an ultrasonicsurgical instrument 1104 and comprises a handpiece 1105 (HP), anultrasonic transducer 1120, a shaft 1126, and an end effector 1122. Theend effector 1122 comprises an ultrasonic blade 1128 acousticallycoupled to the ultrasonic transducer 1120 and a clamp arm 1140. Thehandpiece 1105 comprises a trigger 1143 to operate the clamp arm 1140and a combination of the toggle buttons 1137, 1134 b, 1134 c to energizeand drive the ultrasonic blade 1128 or other function. The togglebuttons 1137, 1134 b, 1134 c can be configured to energize theultrasonic transducer 1120 with the generator 1100.

The generator 1100 also is configured to drive a second surgicalinstrument 1106. The second surgical instrument 1106 is an RFelectrosurgical instrument and comprises a handpiece 1107 (HP), a shaft1127, and an end effector 1124. The end effector 1124 compriseselectrodes in clamp arms 1145, 1142 b and return through an electricalconductor portion of the shaft 1127. The electrodes are coupled to andenergized by a bipolar energy source within the generator 1100. Thehandpiece 1107 comprises a trigger 1145 to operate the clamp arms 1145,1142 b and an energy button 1135 to actuate an energy switch to energizethe electrodes in the end effector 1124. The second surgical instrument1106 can also be used with a return pad to deliver monopolar energy totissue.

The generator 1100 also is configured to drive a multifunction surgicalinstrument 1108. The multifunction surgical instrument 1108 comprises ahandpiece 1109 (HP), a shaft 1129, and an end effector 1125. The endeffector 1125 comprises an ultrasonic blade 1149 and a clamp arm 1146.The ultrasonic blade 1149 is acoustically coupled to the ultrasonictransducer 1120. The handpiece 1109 comprises a trigger 1147 to operatethe clamp arm 1146 and a combination of the toggle buttons 11310, 1137b, 1137 c to energize and drive the ultrasonic blade 1149 or otherfunction. The toggle buttons 11310, 1137 b, 1137 c can be configured toenergize the ultrasonic transducer 1120 with the generator 1100 andenergize the ultrasonic blade 1149 with a bipolar energy source alsocontained within the generator 1100. Monopolar energy can be deliveredto the tissue in combination with, or separately from, the bipolarenergy.

The generator 1100 is configurable for use with a variety of surgicalinstruments. According to various forms, the generator 1100 may beconfigurable for use with different surgical instruments of differenttypes including, for example, the ultrasonic surgical instrument 1104,the RF electrosurgical instrument 1106, and the multifunction surgicalinstrument 1108 that integrates RF and ultrasonic energies deliveredsimultaneously from the generator 1100. Although in the form of FIG. 2,the generator 1100 is shown separate from the surgical instruments 1104,1106, 1108, in another form the generator 1100 may be formed integrallywith any one of the surgical instruments 1104, 1106, 1108 to form aunitary surgical system. As discussed above, the generator 1100comprises an input device 1110 located on a front panel of the generator1100 console. The input device 1110 may comprise any suitable devicethat generates signals suitable for programming the operation of thegenerator 1100. The generator 1100 also may comprise one or more outputdevices 1112. Further aspects of generators for digitally generatingelectrical signal waveforms and surgical instruments are described in USpatent application publication US-2017-0086914-A1, which is hereinincorporated by reference in its entirety.

FIG. 3 illustrates a schematic diagram of a surgical instrument or tool600 comprising a plurality of motor assemblies that can be activated toperform various functions. In the illustrated example, a closure motorassembly 610 is operable to transition an end effector between an openconfiguration and a closed configuration, and an articulation motorassembly 620 is operable to articulate the end effector relative to ashaft assembly. In certain instances, the plurality of motors assembliescan be individually activated to cause firing, closure, and/orarticulation motions in the end effector. The firing, closure, and/orarticulation motions can be transmitted to the end effector through ashaft assembly, for example.

In certain instances, the closure motor assembly 610 includes a closuremotor. The closure 603 may be operably coupled to a closure motor driveassembly 612 which can be configured to transmit closure motions,generated by the motor to the end effector, in particular to displace aclosure member to close to transition the end effector to the closedconfiguration. The closure motions may cause the end effector totransition from an open configuration to a closed configuration tocapture tissue, for example. The end effector may be transitioned to anopen position by reversing the direction of the motor.

In certain instances, the articulation motor assembly 620 includes anarticulation motor that be operably coupled to an articulation driveassembly 622 which can be configured to transmit articulation motions,generated by the motor to the end effector. In certain instances, thearticulation motions may cause the end effector to articulate relativeto the shaft, for example.

One or more of the motors of the surgical instrument 600 may comprise atorque sensor to measure the output torque on the shaft of the motor.The force on an end effector may be sensed in any conventional manner,such as by force sensors on the outer sides of the jaws or by a torquesensor for the motor actuating the jaws.

In various instances, the motor assemblies 610, 620 include one or moremotor drivers that may comprise one or more H-Bridge FETs. The motordrivers may modulate the power transmitted from a power source 630 to amotor based on input from a microcontroller 640 (the “controller”), forexample, of a control circuit 601. In certain instances, themicrocontroller 640 can be employed to determine the current drawn bythe motor, for example.

In certain instances, the microcontroller 640 may include amicroprocessor 642 (the “processor”) and one or more non-transitorycomputer-readable mediums or memory units 644 (the “memory”). In certaininstances, the memory 644 may store various program instructions, whichwhen executed may cause the processor 642 to perform a plurality offunctions and/or calculations described herein. In certain instances,one or more of the memory units 644 may be coupled to the processor 642,for example. In various aspects, the microcontroller 640 may communicateover a wired or wireless channel, or combinations thereof.

In certain instances, the power source 630 can be employed to supplypower to the microcontroller 640, for example. In certain instances, thepower source 630 may comprise a battery (or “battery pack” or “powerpack”), such as a lithium-ion battery, for example. In certaininstances, the battery pack may be configured to be releasably mountedto a handle for supplying power to the surgical instrument 600. A numberof battery cells connected in series may be used as the power source630. In certain instances, the power source 630 may be replaceableand/or rechargeable, for example.

In various instances, the processor 642 may control a motor driver tocontrol the position, direction of rotation, and/or velocity of a motorof the assemblies 610, 620. In certain instances, the processor 642 cansignal the motor driver to stop and/or disable the motor. It should beunderstood that the term “processor” as used herein includes anysuitable microprocessor, microcontroller, or other basic computingdevice that incorporates the functions of a computer's centralprocessing unit (CPU) on an integrated circuit or, at most, a fewintegrated circuits. The processor 642 is a multipurpose, programmabledevice that accepts digital data as input, processes it according toinstructions stored in its memory, and provides results as output. It isan example of sequential digital logic, as it has internal memory.Processors operate on numbers and symbols represented in the binarynumeral system.

In one instance, the processor 642 may be any single-core or multicoreprocessor such as those known under the trade name ARM Cortex by TexasInstruments. In certain instances, the microcontroller 620 may be an LM4F230H5QR, available from Texas Instruments, for example. In at leastone example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4FProcessor Core comprising an on-chip memory of 256 KB single-cycle flashmemory, or other non-volatile memory, up to 40 MHz, a prefetch buffer toimprove performance above 40 MHz, a 32 KB single-cycle SRAM, an internalROM loaded with StellarisWare® software, a 2 KB EEPROM, one or more PWMmodules, one or more QEI analogs, one or more 12-bit ADCs with 12 analoginput channels, among other features that are readily available for theproduct datasheet. Other microcontrollers may be readily substituted foruse with the surgical instrument 600. Accordingly, the presentdisclosure should not be limited in this context.

In certain instances, the memory 644 may include program instructionsfor controlling each of the motors of the surgical instrument 600. Forexample, the memory 644 may include program instructions for controllingthe closure motor and the articulation motor. Such program instructionsmay cause the processor 642 to control the closure and articulationfunctions in accordance with inputs from algorithms or control programsof the surgical instrument 600.

In certain instances, one or more mechanisms and/or sensors such as, forexample, sensors 645 can be employed to alert the processor 642 to theprogram instructions that should be used in a particular setting. Forexample, the sensors 645 may alert the processor 642 to use the programinstructions associated with closing and articulating the end effector.In certain instances, the sensors 645 may comprise position sensorswhich can be employed to sense the position of a closure actuator, forexample. Accordingly, the processor 642 may use the program instructionsassociated with closing the end effector to activate the motor of theclosure drive assembly 620 if the processor 642 receives a signal fromthe sensors 630 indicative of actuation of the closure actuator.

In some examples, the motors may be brushless DC electric motors, andthe respective motor drive signals may comprise a PWM signal provided toone or more stator windings of the motors. Also, in some examples, themotor drivers may be omitted and the control circuit 601 may generatethe motor drive signals directly.

It is common practice during various laparoscopic surgical procedures toinsert a surgical end effector portion of a surgical instrument througha trocar that has been installed in the abdominal wall of a patient toaccess a surgical site located inside the patient's abdomen. In itssimplest form, a trocar is a pen-shaped instrument with a sharptriangular point at one end that is typically used inside a hollow tube,known as a cannula or sleeve, to create an opening into the body throughwhich surgical end effectors may be introduced. Such arrangement formsan access port into the body cavity through which surgical end effectorsmay be inserted. The inner diameter of the trocar's cannula necessarilylimits the size of the end effector and drive-supporting shaft of thesurgical instrument that may be inserted through the trocar.

Regardless of the specific type of surgical procedure being performed,once the surgical end effector has been inserted into the patientthrough the trocar cannula, it is often necessary to move the surgicalend effector relative to the shaft assembly that is positioned withinthe trocar cannula in order to properly position the surgical endeffector relative to the tissue or organ to be treated. This movement orpositioning of the surgical end effector relative to the portion of theshaft that remains within the trocar cannula is often referred to as“articulation” of the surgical end effector. A variety of articulationjoints have been developed to attach a surgical end effector to anassociated shaft in order to facilitate such articulation of thesurgical end effector. As one might expect, in many surgical procedures,it is desirable to employ a surgical end effector that has as large arange of articulation as possible.

Due to the size constraints imposed by the size of the trocar cannula,the articulation joint components must be sized so as to be freelyinsertable through the trocar cannula. These size constraints also limitthe size and composition of various drive members and components thatoperably interface with the motors and/or other control systems that aresupported in a housing that may be handheld or comprise a portion of alarger automated system. In many instances, these drive members mustoperably pass through the articulation joint to be operably coupled toor operably interface with the surgical end effector. For example, onesuch drive member is commonly employed to apply articulation controlmotions to the surgical end effector. During use, the articulation drivemember may be unactuated to position the surgical end effector in anunarticulated position to facilitate insertion of the surgical endeffector through the trocar and then be actuated to articulate thesurgical end effector to a desired position once the surgical endeffector has entered the patient.

Thus, the aforementioned size constraints form many challenges todeveloping an articulation system that can effectuate a desired range ofarticulation, yet accommodate a variety of different drive systems thatare necessary to operate various features of the surgical end effector.Further, once the surgical end effector has been positioned in a desiredarticulated position, the articulation system and articulation jointmust be able to retain the surgical end effector in that position duringthe actuation of the end effector and completion of the surgicalprocedure. Such articulation joint arrangements must also be able towithstand external forces that are experienced by the end effectorduring use.

FIG. 4 illustrates a portion of a surgical instrument 10000 that mayaddress many, if not all, of the aforementioned challenges. As can beseen in FIG. 4, the surgical instrument 10000 includes a proximal shaftsegment 10100 that may be operably coupled to a housing (not shown) thatmay support one or more control motors and control systems forcontrolling the operation and actuation of a surgical end effector 10200that is operably coupled to the proximal shaft segment 10100. Forexample, the housing may comprise a handheld housing of various typesdisclosed herein or the housing may comprise a portion of an automatedsystem or robotically-controlled system that is used to manipulate andoperate the surgical end effector 10200 that is operably coupled to theproximal shaft segment 10100. The handheld housing may comprisetrigger(s) and or switches for controlling motors and/or mechanicalsystems configured to generate control motions and actions.

In the illustrated example, the proximal shaft segment 10100 defines ashaft axis SA that extends centrally through the proximal shaft segment10100 and the surgical end effector 10200 for reference purposes. Theproximal shaft segment 10100 comprises a proximal outer shaft tube 10110that may extend from the housing or otherwise interface therewith. Theproximal outer shaft tube 10110 is hollow or is at least partiallyhollow to accommodate various drive members and components employed toconvey control motions and signals between control systems in thehousing and the surgical end effector 10200. In at least onearrangement, the proximal outer shaft tube 10110 is rigid or at leastpartially rigid and defines a maximum outer diameter “O.D.”. Otherarrangements are contemplated wherein the proximal outer shaft tube10110 is flexible or at least partially flexible or selectivelycontourable.

FIG. 4 illustrates portions of a trocar cannula 10010 that has an innerdiameter “I.D.” that is greater than the O.D. of the proximal outershaft tube 10110. For example, the inner diameter I.D. may be at least 1mm larger than the O.D. of the proximal outer shaft tube 10110 tofacilitate passage of the proximal outer shaft tube 10110 therethrough.As can be seen in FIG. 4, the proximal shaft segment 10100 is attachedto a surgical end effector frame assembly 10210 by an articulation jointgenerally designated as 10300. In the illustrated arrangement, thearticulation joint 10300 comprises a proximal shaft frame member 10310that extends distally out of a distal end 10102 of the proximal shaftsegment 10100. The proximal shaft frame member 10310 may be attached tothe proximal outer shaft tube 10110 by, for example, welding, adhesive,etc. As can be seen in FIG. 5, the proximal shaft frame member 10310comprises a U-shaped cradle portion that includes proximally extendingattachment arms 10312, 10314, wherein attachment arm 10312 is located onone side of the shaft axis SA and the attachment arm 10314 is located onan opposite side of the shaft axis SA.

In certain instances, the articulation joint 10300 further comprises aproximal end effector frame member 10320 that also comprises a portionof the end effector frame assembly 10210. The proximal end effectorframe member 10320 comprises two upstanding support sides 10322, 10324that define a U-shaped cradle 10326. The proximal end effector framemember 10320 is received between the attachment arms 10312, 10314 and ispivotally supported therein by an articulation pin 10330 that defines anarticulation axis AA. The articulation joint 10300 facilitates selectivearticulation of the proximal end effector frame member 10320 throughranges of articulation on each side of the shaft axis SA. For example,the articulation joint 10300 facilitates articulation of the proximalend effector frame member 10320 from an unarticulated position (FIGS.6-9) to a first maximum articulated position in a first articulationdirection A₁ on one side of the shaft axis SA (FIG. 5 and FIGS. 10-12)as well as to a second maximum articulated position in a secondarticulation direction A₂ (FIGS. 13-15).

In various instances, the surgical end effector 10200 is selectivelyarticulated about the articulation axis AA relative to the proximalshaft segment 10100 by an articulation system generally designated as10400. In one example, the articulation system 10400 comprises a rightproximal link 10410 located on a right side of the shaft axis, a leftproximal link 10430 located on a left side of the shaft axis and acentrally disposed second link 10450. See FIG. 6. The right proximallink 10410 comprises a right proximal link body 10412 that is roughlyL-shaped and comprises a right proximal link proximal end 10414 and aright proximal link distal end 10416. Similarly, the left proximal link10430 comprises a left proximal link body 10432 that is roughly L-shapedand comprises a left proximal link proximal end 10434 and a leftproximal link distal end 10436. In the illustrated example, the rightproximal link proximal end 10414 is pivotally supported relative to theattachment arm 10312 and the left proximal link proximal end 10434 ispivotally supported relative to the attachment arm 10314. The rightproximal link proximal end 10414 is pivotally coupled to the attachmentarm 10312 and the left proximal link proximal end 10434 is pivotallycoupled to the attachment arm 10314 by a first link pin 10420. The firstlink pin 10420 defines a first link axis FLA that is transverse to theshaft axis SA and facilitates pivotal travel of the right proximal link10410 and the left proximal link 10430 about the first link axis FLArelative to the proximal shaft frame member 10310. See FIGS. 5 and 11.

Turning to FIG. 6, in certain instances, the second link 10450 issubstantially U-shaped and comprises a second link proximal end 10452that is received between the right proximal link distal end 10416 andthe left proximal link distal end 10436 and spans the distancetherebetween. The second link proximal end 10452 is pivotally coupled tothe right proximal link distal end 10416 and the left proximal linkdistal end 10436 by a second link pin 10422. See FIG. 7. The second linkpin 10422 defines a second link axis SLA that is transverse to the shaftaxis SA and facilitates relative pivotal travel of the second link 10450relative to the right proximal link 10410 and the left proximal link10430 about the second link axis SLA. The second link 10450 furthercomprises a right second link arm 10454 and a left second link arm 10456that each extend distally from the second link proximal end 10452. Theright second link arm 10454 and the left second link arm 10456 arepivotally attached to the proximal end effector frame member 10320 by athird link pin 10424. The third link pin 10424 defines a third link axisTLA that is transverse to the shaft axis SA and facilitates pivotaltravel of the second link 10450 relative to the proximal end effectorframe member 10320 about the third link axis TLA. See FIGS. 7 and 9.

The articulation system 10400 further comprises an axially movablearticulation actuator 10470 that is configured to apply axialarticulation motions to the right proximal link 10410 and the leftproximal link 10430. In various instances, the articulation actuator maybe axially aligned with the shaft axis SA. In the illustratedarrangement, the articulation actuator 10470 comprises an articulationshaft 10472 that includes a distal end formation 10474 that is pivotallycoupled to the right proximal link 10410 and the left proximal link10430. For example, the distal end formation 10474 comprises a rightprotruding right link pin 10476 that is configured to pivotally extendinto a right pivot hole 10419 that is provided in a right first pivotlocation 10418 through a right first corner portion 10417 of the rightproximal link 10410. See FIG. 9. Stated another way, the right link pin10476 pivotally engages the right proximal link 10410 at a right firstpivot location 10418 that is between the right proximal link proximalend 10414 and the right proximal link distal end 10416 of the rightproximal link 10410. Likewise, the distal end formation 10474 comprisesa left protruding left link pin 10478 that is configured to pivotallyextend into a left pivot hole 10439 that is provided in a left firstpivot location 10438 that is through a left first corner portion 10437of the left proximal link 10430. Stated another way, the left link pin10478 pivotally engages the left proximal link 10430 at a left firstpivot location 10438 that is located between the left proximal linkproximal end 10434 and the left proximal link distal end 10436 of theleft proximal link 10430.

The surgical end effector 10200 may be selectively articulated about thearticulation axis AA by moving the articulation actuator 10470 in aproximal direction PD or a distal direction DD. For example, toarticulate the surgical end effector 10200 in the first articulationdirection A₁, the articulation actuator 10470 is axially moved in aproximal direction PD. See FIG. 5 and FIGS. 10-12. To articulate thesurgical end effector 10200 in the second articulation direction A₂, thearticulation actuator 10470 is axially moved in a distal direction DD.See FIGS. 13-15. The articulation actuator 10470 extends through theproximal shaft segment 10100 to operably interface with an articulationdrive system supported in the housing.

A variety of axial drive system arrangements are known. FIG. 16illustrates a portion of an axial drive system 10500 that may beemployed (in or on the housing) to apply axial drive motions to thearticulation actuator 10470, for example. In certain instances, as canbe seen in FIG. 16, the axial drive system 10500 comprises a fixedproximal shaft 10510 that includes a left handed threaded segment 10512that is supported in a drive shaft 10520 (shown in phantom lines). Thethreaded segment 10512 is in threaded engagement with a correspondingsegment of threads 10522 in the drive shaft 10520. The drive shaft 10520is supported for rotational travel by a drive gear 10530 that isjournaled thereon. In various instances, the drive gear 10530 maymeshingly interface with a motor driven gear (not shown) that issupported in or on the housing. In one embodiment, the axial drivesystem 10500 further includes a distal shaft 10540 that includes a righthanded thread segment 10542 that is supported in a distal portion of thedrive shaft 10520. The threaded segment 10542 is in threaded engagementwith a corresponding segment of threads 10524 in the drive shaft 10520.In the illustrated arrangement, for example, one rotation of the drivegear 10530 in a counterclockwise CCW direction may result in 0.050inches of linear travel of the distal shaft 10540 in the distaldirection. Likewise, rotation of the drive gear 10530 in a clockwisedirection CW will cause the distal shaft 10540 to linearly move in adistal direction DD. In certain instances, the distal shaft 10540 mayactually comprise the articulation actuator 10470 or otherwise operablyinterface therewith to provide desired axial articulation controlmotions thereto. In at least one arrangement, for example, the amount ofarticulation force applied to the articulation actuator 10470 employingsuch arrangement may be between 10-30 pounds as it adjusts dynamically.In some instances, an ideal amount of articulation force may be 20pounds, for example. The static resist load of such arrangement may beas high as 80-150 pounds with a practical load of 100 pounds on thedistal shaft 10540. Local pivotal termination of the articulationactuator close to the articulation joint may also minimize the chance ofbuckling. In various instances, buckling support could be integratedinto the support of the drive gear 10530 or a spring biased or slidingjoint bushing could be employed on the drive shaft 10520 to allow it topivot but not buckle under compressive loads.

Turning next to FIG. 17 and FIG. 18, to increase the range ofarticulation travel afforded by the articulation joint 10300, in atleast one arrangement, the second link proximal end 10452 includes arecessed area 10453 configured to provide additional clearance for theproximal end effector frame member 10320 when the proximal end effectorframe member 10320 is articulated to a maximum articulation angle. Alsoin at least one arrangement, the right proximal link 10410 includes acontoured or arcuate outer surface 10415 and the left proximal link10430 includes a contoured or arcuate outer surface 10435. See FIG. 8.Similarly, the right second link arm 10454 has a contoured or arcuateouter surface 10455 and the left second link arm 10456 has a contouredor arcuate outer surface 10457. Such contoured link configurations maybe much stronger than prior uncontoured or relatively flat linkarrangements that have been employed in other articulation jointarrangements. As can be seen in FIG. 8, such arcuate surfaces on theright proximal link 10410 and the left proximal link 10430 generallyalign with the internal diameter ID of the proximal outer shaft tube10110.

As can be seen in FIG. 21, the right proximal link 10410 comprises aright cut out area 10411 that enables the right proximal link 10410 toarticulate over top of a right end of 10334 articulation pin 10330. Sucharrangements serve to facilitate additional articulation travel of thesurgical end effector 10200 about the articulation axis AA. Further, invarious instances, to provide additional strength to the right proximallink 10410 while facilitating additional articulation travel, a rightarticulation boss or rib segment 10413 is formed on an inside surface ofthe right proximal link 10410. The right articulation rib segment 10413provides additional pivotal support to the right proximal link 10410 asit pivots relative to the right link pin 10476. However, the rightarticulation rib segment 10413 only extends partially around the rightlink pin 10476 to provide additional pivotal clearance for the rightproximal link 10410 to pivot about the right link pin 10476.

Likewise, the left proximal link 10430 comprises a left cut out area10431 that enables the left proximal link 10430 to articulate over topof a left end 10332 of the articulation pin 10330. See FIG. 20. Sucharrangements serve to facilitate additional articulation travel of thesurgical end effector 10200 about the articulation axis AA. Further, invarious instances, to provide additional strength to the left proximallink 10430 while facilitating additional articulation travel, a leftarticulation boss or rib segment 10433 is formed on an inside surface ofthe left proximal link 10430. See FIG. 19. The left articulation ribsegment 10433 provides additional pivotal support to the left proximallink 10430 as it pivots relative to the left link pin 10478. However,the left articulation rib segment 10433 only extends partially aroundthe left link pin 10478 to provide additional pivotal clearance for theleft proximal link 10430 to pivot about the left link pin 10478.

The above-described articulation joint arrangement, as well as the otherarticulation joint arrangements disclosed herein may represent vastimprovements over prior articulation joint arrangements that compriserelatively planar articulation links that are located or attachedbetween the shaft portion of the device and the surgical end effectoronly on one side of the shaft axis. Because the right proximal link islocated on a right side of the shaft axis SA and the left proximal linkis located on a left side of the shaft axis SA and the second link spansthe shaft axis SA to be coupled to the right proximal link and leftproximal link, the lateral stability of such articulation joint may beenhanced. For example, such articulation joint may provide improvedresistance to external lateral loads experienced by the end effectorwhen interacting with adjacent tissue or organs or to other externalforces that are applied to the end effector during use.

In various instances, as can be seen in FIGS. 4, 22, and 23, thesurgical end effector 10200 comprises a first jaw 10250 and a second jaw10270. The first jaw 10250 and the second jaw 10270 are each pivotallysupported on the end effector frame assembly 10210 and are movablebetween an open position and a closed position upon an application ofaxial control motions applied to one of the jaws 10250, 10270. The firstjaw 10250 and the second jaw 10270 may comprise any of the jawarrangements disclosed herein, for example. Turning specifically toFIGS. 22 and FIG. 23, the end effector frame assembly 10210 comprises adistal frame member 10220 that is rotatably supported in a proximalframe housing 10230 that is fixedly attached to the proximal endeffector frame member 10320. For example, the proximal frame housing10230 may be attached to the proximal end effector frame member 10320 bywelding, adhesive, etc. In the illustrated example, the distal framemember 10220 comprises a proximal barrel portion 10222 that isconfigured to rotate within proximal frame housing 10230 as will bediscussed in further detail below.

In various instances, the first jaw 10250 is pivotally pinned to thedistal frame member 10220 for selective pivotal travel relative theretoabout a first jaw axis FJA defined by a first jaw pin 10221. See FIG.23. The second jaw 10270 is pivotally pinned to the first jaw 10250 forselective pivotal travel relative to the first jaw 10250 about a secondjaw axis SJA that is defined by a second jaw pin 10271. In certaininstances, the second jaw axis SJA is parallel to the first jaw axisFJA. The first jaw axis FJA and the second jaw axis SJA are bothtransverse to the shaft axis SA. In at least one arrangement as shown inFIG. 23, the second jaw 10270 is configured to receive axial jaw controlmotions from an end effector drive member 10600. In certain instances,the end effector drive member 10600 comprises a flexible rotary shaft10602 that is capable of rotation while maintaining an ability to bendand flex to accommodate articulation of the surgical end effector 10200in the manners described herein. As can be seen in FIG. 24, the distalend formation 10474 of the articulation shaft 10472 comprises an arcuatesupport surface 10479 and a proximal end portion 10327 of the proximalend effector frame member 10320 comprises an arcuate support surface10328. The arcuate support surfaces 10479 and 10328 serve to support theflexible rotary drive shaft 10602 as the surgical end effector 10200 isarticulated on each side of the shaft axis SA through an entire range ofarticulation.

Returning to FIGS. 22 and 23, a proximal end 10272 of the second jaw10270 comprises a second jaw attachment pin 10274 that is configured tooperably interface with an actuator yoke assembly 10610. In theillustrated example, the actuator yoke assembly 10610 comprises aproximal yoke housing segment 10612 and a distal yoke housing segment10614 that are coupled together to facilitate relative rotationtherebetween. For example, the proximal yoke housing segment 10612 andthe distal yoke housing segment 10614 may be coupled by a spring clip10613 or other faster arrangement such that the proximal yoke housingsegment 10612 is rotatable relative to the distal yoke housing segment10614 while remaining attached thereto. As can be seen in FIGS. 22 and26, the distal yoke housing segment 10614 includes an elongate slot10615 that facilitates vertical movement of the second jaw attachmentpin 10274 therein. The first jaw 10250 comprises a cam surface 10252that is configured to cammingly interact with the distal yoke housingsegment 10614 when the actuator yoke assembly 10610 is driven distallyto cam the first jaw 10250 into an open position about the first jaw pin10221. A distal end 10604 of the flexible drive shaft 10602 is rotatablycoupled to the actuator yoke 10610 to facilitate rotation of theflexible drive shaft 10602 relative to the actuator yoke assembly 10610.In one arrangement, the distal end 10604 comprises a ball feature 10606that is rotatably housed within a rotation housing 10616 formed withinthe distal yoke housing segment 10614 and the proximal yoke housingsegment 10612. The actuator yoke assembly 10610 is received within abore 10224 within the proximal barrel portion 10222 to facilitate axialtravel of the distal yoke housing segment 10614 therein as well as axialand rotational travel of the proximal yoke housing segment 10612therein.

To facilitate locking of the surgical end effector 10200 in a desiredrotary position about the shaft axis SA, a series of radial lockinggrooves 10226 are formed in a proximal end of the barrel portion 10222.See FIGS. 25 and 26. The series of radial locking grooves 10226 areconfigured to be lockingly engaged by a lock insert 10340 that isreceived between the upstanding support sides 10322, 10324 of theproximal effector frame member 10320. In various arrangements, the lockinsert 10340 is biased in a distal direction into locking engagementwith the locking grooves 10226 by a biasing member or a spring (notshown). A flexible unlocking cable 10342 or other flexible actuator iscoupled to the lock insert 10340 and extends through the proximal shaftsegment 10100 to interface with a control system in the housing. Invarious instances, for example, the flexible unlocking cable 10342 mayinterface with a motor or other control arrangement configured toselectively pull the unlocking cable proximally to move the lock insertout of locking engagement with the locking grooves 10226 on the proximalbarrel portion 10222.

Referring to FIG. 22, a threaded member 10630 is mounted on a bushing10620 that is non-rotatably mounted to the flexible rotary drive shaft10602. The threaded member 10630 is also attached to the proximal yokehousing segment 10612 by welding, adhesive, molding, etc. Thus, rotationof the flexible rotary drive shaft 10602 will result in the rotation ofthe threaded member 10630 as well as the proximal yoke housing segment10612, but not the distal yoke housing segment 10614. The threadedmember 10630 is in threaded engagement with a plurality of internalthreads 10229 formed in the proximal barrel portion 10222 of the distalframe member 10220. When the lock insert 10340 is in locking engagementwith the locking grooves 10226 in the proximal barrel portion 10222,rotation of the rotary drive shaft 10602 and the threaded member 10630in a first direction will drive the actuator yoke assembly 10610 in thedistal direction DD to move the first jaw 10250 and the second jaw 10270into an open position. Because the lock insert 10340 is in lockingengagement with the lock grooves 10226, the proximal barrel portion10222 (and the surgical end effector 10200) is prevented from rotatingabout the shaft axis SA when the rotary flexible drive shaft 10602 isrotated. Instead, the threaded drive nut 10630 rotates within theproximal barrel portion 10222 and moves distally to drive the actuatoryoke assembly 10610 in the distal direction as well. While the proximalyoke housing segment 10612 rotates, the distal yoke housing segment10614 does not rotate.

The surgical end effector 10200 of the illustrated example is alsoselectively rotatable about the shaft axis SA to further enhance thepositionability of the surgical end effector 10200 during use. To rotatethe surgical end effector 10200 about the shaft axis SA, the unlockingcable 10342 is pulled proximally to cause the lock insert 10340 todisengage the lock grooves 10226 in the proximal barrel portion 10222.Thereafter, the flexible rotary drive shaft 10602 is rotated in adesired direction. In such instance, there is enough friction betweenthe threaded member 10630 and the internal threads 10229 formed in theproximal barrel portion 10222 of the distal frame member 10220 such thatrotation of the threaded member 10630 will cause the proximal barrelportion 10222 (and the surgical end effector 10200) to rotate about theshaft axis SA.

In one application, the surgical instrument 10000 may be used as followsin connection with performing a laparoscopic procedure wherein a trocarhas been installed in a patient. To insert the surgical end effector10200 through the trocar cannula 10010, the clinician (or roboticcontrol system) may have to first actuate the articulation drive systemto cause the articulation shaft 10472 to move the surgical end effector10200 into an unarticulated position if it is not already in thatposition. See FIG. 4. Also, in certain instances, the drive system thatcontrols the flexible rotary drive shaft 10602 may need to be actuatedto bring the first jaw 10250 and the second jaw 10270 into the fullyclosed position if the first jaw 10250 and the second jaw 10270 are notalready in that position. Once the surgical end effector 10200 is in theunarticulated position with the first jaw 10250 and the second jaw 10270in the closed position, the surgical end effector 10200 may be insertedthrough the trocar cannula 10010 into the surgical site. Once thesurgical end effector 10200 has been inserted into the surgical site,the clinician or robotic control system may then actuate thearticulation drive system in an appropriate manner to articulate thesurgical end effector 10200 into a desired articulated position relativeto the tissue to be treated (target tissue). In addition, if necessary,the unlocking cable 10342 may be actuated to unlock the surgical endeffector 10200 to permit the surgical end effector 10200 to be rotatedabout the shaft axis SA into a desired rotary position. Once in thedesired rotary position, the unlocking cable 10342 may then bedeactivated to permit the lock insert 10340 to return to the lockedposition to retain the end effector 10200 in the desired rotaryposition. The surgical end effector 10200 may be rotated before and/orafter the surgical end effector 10200 has been articulated. Thereafter,the drive system may be actuated to rotate the flexible rotary driveshaft 10602 in a first rotary direction to drive the actuator yokeassembly 10610 distally to open the first and second jaws 10250, 10270.Once the jaws 10250, 10270 are open and the target tissue has beenpositioned therein, the drive system may again be actuated to rotate theflexible rotary drive shaft 10602 in a second rotary direction to drivethe actuator yoke assembly 10610 proximally to pull the first and secondjaws 10250, 10270 to a closed position to clamp the target tissuetherebetween. Once the tissue has been treated, the jaws 10250, 10270are opened to disengage the treated tissue and then returned to a closedposition. The surgical end effector 10200 is returned to theunarticulated position to enable the surgical end effector 10200 to bewithdrawn from the patient through the trocar cannula.

To facilitate transfer of electric signals/power between the housing andthe surgical end effector 10200 and, more particularly, to one or bothof the first and second jaws, conductors may be provided through theproximal shaft segment 10100 and span the articulation joint 10300 toterminate in a series of contacts supported in the proximal framehousing 10230. In the example illustrated in FIG. 25, three fixedcontacts 10240, 10242, 10244 are mounted in the proximal frame housing10230. An annular contact 10223 is supported around the perimeter of theproximal barrel portion 10222 of the distal frame member 10220. Thefixed contact 10240 is in electrical contact with the annular contact10223 as the distal frame member 10220 is rotated about the shaft axisSA. An annular contact 10225 is supported around the perimeter of theproximal barrel portion 10222 of the distal frame member 10220. Thefixed contact 10242 is supported in electrical contact with the annularcontact 10225 as the distal frame member 10220 is rotated about theshaft axis SA. An annular contact 10227 is supported around theperimeter of the proximal barrel portion 10222 of the distal framemember 10220. The fixed contact 10244 is in electrical contact withannular contact 10227 as the distal frame member 10220 is rotated aboutthe shaft axis SA. The fixed contacts 10240, 10242, 10244 may alsoextend into one or both of the first and second jaws 10250, 10270 totransmit signals/power thereto.

FIGS. 28 and 29 illustrate portions of the surgical instrument 10000 forfacilitating transfer of electric signals/power between a housing 10900and the surgical end effector 10200 (FIG. 4). As can be seen in FIG. 29,the proximal shaft segment 10100 may comprise a U-shaped hollow tube10910 that supports a right shaft frame segment 10920 and a left shaftframe segment 10930. The right shaft frame segment 10920 and left shaftframe segment 10930 serve to rotatably support the rotary drive shaft10602, the articulation shaft 10472, and the locking cable arrangement10342 within the U-shaped hollow tube 10910. The right shaft framesegment 10920 and left shaft frame segment 10930 also support a flexcircuit 10940 that may communicate with various control components/powersources within the housing 10900 and spans across the articulation joint10300. The flex circuit 10940 may be coupled to the three fixed contacts10240, 10242, 10244 that are mounted in the proximal frame housing10230. Such arrangement facilitates transfer of electrical power betweenthe housing 10900 and the surgical end effector 10200 while facilitatingarticulation and rotation of the surgical end effector 10200 relative tothe proximal shaft segment 10100. As can also be seen in FIGS. 28 and29, the shaft segment 10100 may be retained together by a layer ofshrink wrap 10950 which may also prevent the infiltration of fluidstherein.

FIGS. 30 and 31 illustrate an alternative actuator yoke 10610′ that isrotatably attached to a flexible rotary drive shaft 10602′. In onearrangement, the flexible rotary drive shaft 10602′ comprises a torquecable that has a diameter of approximately 0.039 inches. In certaininstances, the threaded member 10630′ comprises a coupler portion 10632that is configured to be snapped into a cavity 10618 in an actuator yoke10610′. When the coupler portion 10632 is attached to the actuator yoke10610′, the coupler portion 10632 is rotatable relative to the actuatoryoke 10610′. Thus, rotation of the flexible rotary drive shaft 10602′and the threaded member 10630′ will not cause the actuator yoke 10610′to rotate. The actuator yoke 10610′ otherwise operates in the mannerdescribed above.

FIGS. 32 and 33 illustrates another actuator yoke 10610″ that isrotatable relative to the flexible rotary drive shaft 10602″. In thisarrangement, the distal end of the flexible rotary drive shaft 10602″ isinserted into an insert assembly 10629″ that comprises a threaded member10630″ and a proximal yoke portion 10612″ that has a retainer head10615″ formed thereon that defines an annular yoke groove 10617″. Theinsert assembly 10629″ may be molded onto or crimped onto the distal endof the rotary drive shaft 10602″. As can be seen in FIGS. 32 and 33, theactuator yoke 10610″ comprises a clip 10619 that extends into the yokegroove 10617″. Such arrangement facilitates relative rotation betweenthe actuator yoke 10610″ and the insert assembly 10629″. The actuatoryoke 10610″ that may otherwise operate in the manners described above.

FIGS. 34-37 illustrate an alternative arrangement for rotatablysupporting a proximal barrel portion 10222′ of a distal frame member10220′ within a proximal frame housing 10230′. As can be seen in FIGS.34-36, a spring clip 10260 is received within a clip groove 10232′ thatis provided in a portion of the perimeter of the proximal frame housing10230′. The clip groove 10232′ opens into a pair ofdiametrically-opposed clip notches 10234′ that are configured to receiveportions of clip ends 10262 of the spring clip 10260 therein. The clipends 10262 ride on the outer perimeter of the proximal barrel portion10222′ to rotatably support the proximal barrel portion 10222′ withinthe proximal frame housing 10230′. Such arrangement may also serve toreduce the amount of rotary friction between the proximal frame housing10230′ and the proximal barrel portion 10222′.

FIG. 38 illustrates an alternative proximal barrel portion 10222″ and alocking cable arrangement 10342′. In the example illustrated in FIGS. 38and 39, a proximal end of the proximal barrel portion 10222″ includes aplurality of radially arranged locking cavities 10226′ therein that areconfigured to be lockingly engaged by the locking cable or lockingmember 10342′ in the manner described above. In this arrangement, aflexible locking cable or locking member 10342′ is attached to a lockinsert 10340′ that is slidably supported in the proximal effector framemember 10320. See FIG. 38. A distal end of the locking cable or lockingmember 10342′ protrudes distally out of the locking insert 10340′ whichis biased distally into a locking position by a spring (not shown). Theflexible unlocking cable or unlocking member 10342′ extends through theproximal shaft segment 10100 to interface with a control system in thehousing. For example, in certain instances, the flexible unlocking cableor unlocking member 10342′ may interface with a motor or other controlarrangement to selectively pull the unlocking cable or unlocking member10342′ proximally to move the distal end of the unlocking cable orunlocking member 10342′ out of locking engagement with the lockingcavities 10226′ on the proximal barrel portion 10222″.

As can be seen in FIG. 39, in this example, three fixed contacts 10240′,10242′, 10244′ are mounted in a proximal frame housing 10230′. Anannular contact 10223′ is supported around a stepped portion of theperimeter of the proximal barrel portion 10222″ of the distal framemember 10220″. The fixed contact 10240′ is in contact with the annularcontact 10223′ as the distal frame member 10220″ is rotated about theshaft axis SA. An annular contact 10225′ is supported around the steppedperimeter of the proximal barrel portion 10222″ of the distal framemember 10220″. The fixed contact 10242′ is in contact with the annularcontact 10225′ as the distal frame member 10220″ is rotated about theshaft axis SA. An annular contact 10227′ is supported around the steppedperimeter of the proximal barrel portion 10222″ of the distal framemember 10220″. The fixed contact 10244′ is in contact with as theannular contact 10227′ as the distal frame member 10220″ is rotatedabout the shaft axis SA. In various instances, the contacts 10240′,10242′, 10244′ may also extend into one or both of the first and secondjaws 10250, 10270 to transmit signals/power thereto. Such arrangementfacilitates transfer of electrical power/signals between the housing andthe surgical end effector 10200 while facilitating articulation androtation of the surgical end effector 10200 relative to the proximalshaft segment 10100.

FIGS. 40-44 illustrate an alternative articulation joint 10300′ that isactuated by a right articulation actuation cable or push rod 10480 and aleft articulation actuation cable or push rod 10482. In variousinstances, the cables/push rods 10480, 10482 must be sufficiently rigidso as to be capable of applying a pushing motion to the articulationjoint yet be flexible enough to accommodate full joint articulation.These cables/push rods may be configured to move in opposite directionsduring articulation of the end effector. In other instances, the cablesmay be completely flexible such that articulation is accomplished bypulling on one of the cables and allowing the opposing cable to travelwith the articulation joint to accommodate the articulation. To returnthe end effector to an unarticulated position, the opposing cable ispulled and the first cable is permitted to travel with the joint to theunarticulated position.

The right articulation actuation cable 10480 extends through theproximal shaft frame 10310′ and the proximal outer shaft tube (notshown). The right articulation cable 10480 is attached to the rightarticulation rib segment 10413′ that protrudes from the right proximallink 10410′. The left articulation cable 10482 extends through theproximal shaft frame 10310′ that has proximally extending attachmentarms 10312′, 10314′ and is attached to the left articulation rib 10433′that protrudes from the left proximal link 10430′. The rightarticulation cable 10480 extends around a right support member 10315′that protrudes inward from the attachment arm 10312′ and the leftarticulation actuation cable 10482 extends around a left support member10316′ that protrudes inwardly from the attachment arm 10314′. Invarious instances, the right articulation actuation cable 10480 and theleft articulation actuation cable 10482 may be controlled by amotor-controlled drum or other control arrangement that is/are supportedby the housing, for example. As can be seen in FIG. 41, a rightclearance groove 10453′ is provided in the second link proximal end10452′ of the centrally disposed second link 10450′ to accommodate theright articulation actuation cable 10480 during articulation. Likewise,a left clearance groove 10455′ is also provided in the second linkproximal end 10452′ of the centrally disposed second link 10450′ toaccommodate the left articulation actuation cable 10482 duringarticulation. See FIG. 42. FIGS. 42-44 illustrate articulation of thearticulation joint 10300′ using the cables 10480, 10482. FIGS. 45 and 46illustrate an alternative articulation joint 10300″ wherein the leftarticulation actuation cable 10482 is routed on the outside of theproximal shaft frame 10310′ and is received within a clearance groove10484 in the left proximal link 10430′ and is attached thereto. Thisembodiment only employs one articulation actuation cable 10482, but aright articulation cable (not shown) could also be employed.

FIGS. 47-49 illustrate another surgical instrument 10000′ that comprisesa surgical end effector 10200′. In various instances, surgical endeffector 10200′ may be identical to surgical end effector 10200 exceptfor the differences discussed below. The surgical end effector 10200′comprises an end effector frame assembly 10210′ that comprises a distalframe member 10720 that is rotatably supported in a proximal framehousing 10230. The proximal frame housing 10230 is fixedly attached tothe proximal end effector frame member 10320. For example, the proximalframe housing 10230 may be attached to the proximal end effector framemember 10320 by welding, adhesive, etc. In the illustrated example, thedistal frame member 10720 is non-rotatably attached to a proximal barrelmember 10722 that is configured to rotate within proximal frame housing10230 as will be discussed in further detail below. A distal end of theproximal barrel member 10722 comprises a plurality of radial grooves orrecesses therein that are configured to be lockingly engaged by alocking insert (not shown) and/or an unlocking cable (not shown) in thevarious manners described herein.

In the illustrated example, the first jaw 10250 is pivotally pinned tothe distal frame member 10720 for selective pivotal travel relativethereto about a first jaw axis FJA defined by a first jaw pin 10221. Thesecond jaw 10270 is pivotally pinned to the first jaw 10250 forselective pivotal travel relative to the first jaw 10250 about a secondjaw axis SJA that is defined by a second jaw pin 10271. In theillustrated example, the surgical end effector 10200′ employs actuatoryoke assembly 10710 that differs in some aspects from actuator yokeassembly 10610. In the illustrated example, the actuator yoke assembly10710 comprises an elongate slot 10715 that facilitates verticalmovement of the second jaw attachment pin 10274 therein. See FIG. 50.The cam surface 10252 of the first jaw 10250 is configured to camminglyinteract with the actuator yoke assembly 10710 when the actuator yokeassembly 10710 is driven distally to cam the first jaw 10250 into anopen position about the first jaw pin 10221.

In certain instances, an end effector drive member 10600′ comprises aflexible rotary shaft 10602′ that is capable of rotation whilemaintaining an ability to bend and flex to accommodate articulation ofthe surgical end effector 10200′ in the manners described herein. Invarious instances, the flexible rotary shaft 10602′ operably interfaceswith a motor or other source of rotary motion supported in the housingand comprises a laser-cut hollow tube that is capable of flexing orbending to accommodate articulation of the surgical end effector 10200′.As can be see FIG. 49, a threaded shaft member 10750 protrudesproximally from the actuator yoke assembly 10710 and is threadablyreceived within a threaded passage 10729 in the proximal barrel member10722 and is coupled to the flexible rotary shaft 10602′. The threadedshaft member 10750 is rotatably coupled to the actuator yoke assembly10710 to enable the threaded shaft member 10750 to rotate relative tothe actuator yoke 10710 assembly while remaining attached thereto, asdescribed herein.

In certain instances, the first and second jaws 10250, 10270 are openedand closed as follows. To open and close the jaws 10250, 10270, as wasdiscussed in detail above, the lock insert is in locking engagement withthe proximal barrel member 10722 to prevent the rotation thereof.Thereafter, rotation of the rotary drive shaft 10602′ in a firstdirection will rotate the threaded shaft member 10750 within thethreaded bore or passage 10729 in the proximal barrel member 10722 anddrive the actuator yoke assembly 10710 in the distal direction DD tomove the first jaw 10250 and the second jaw 10270 toward an openposition. Because the locking insert is in locking engagement with theproximal barrel member 10722, the surgical end effector 10200′ isprevented from rotating about the shaft axis SA when the rotary flexibledrive shaft 10602′ is rotated. Thus, rotation of the rotary drive shaft10602′ in a first direction will axially drive the actuator yoke 10710distally when the locking insert is in locking engagement with theproximal barrel member 10722. Rotation of the rotary drive shaft 10602′in a second direction opposite the first direction will axially drivethe actuator yoke 10710 proximally and pull the jaws 10250, 10270 towarda closed position.

To rotate the surgical end effector 10200′ about the shaft axis SA, theunlocking cable is pulled proximally to cause the locking insert todisengage the lock grooves in the proximal barrel member 10722.Thereafter, the flexible rotary drive shaft 10602′ is rotated in adesired direction. In such instance, there is enough friction betweenthe threaded shaft 10750 and the internal threads 10729 defined in theproximal barrel member 10722 such that rotation of the threaded shaft10750 will cause the proximal barrel portion 10722 (and the surgical endeffector 10200′) to rotate about the shaft axis SA.

In certain instances to facilitate transfer of electric signals/powerfrom a housing to the surgical end effector 10200′ and more particularlyto one or both of the first and second jaws 10250, 10270, conductors maybe provided through the proximal shaft segment 10100 and span thearticulation joint 10300 to terminate in a series of contacts supportedin the proximal frame housing 10230. In various instances, three fixedcontacts 10240, 10242, 10244 are mounted in the proximal frame housing10230. See, e.g., FIG. 25. An annular contact 10223 is supported aroundthe perimeter of the proximal barrel member 10722 of the distal framemember 10720. The fixed contact 10240 is configured to be in electricalcontact with the annular contact 10223 as the distal frame member 10720is rotated about the shaft axis SA. An annular contact 10225 issupported around the perimeter of the proximal barrel member 10722 ofthe distal frame member 10720. The fixed contact 10242 is configured tobe in electrical contact with as the annular contact 10225 as the distalframe member 10720 is rotated about the shaft axis SA. An annularcontact 10227 is supported around the perimeter of the proximal barrelmember 10722 of the distal frame member 10720. The fixed contact 10244is configured to be in electrical contact with the annular contact 10227as the distal frame member 10720 is rotated about the shaft axis SA. Thecontacts 10240, 10242, 10244 may also extend into one or both of thefirst and second jaws 10250, 10270 to transmit signals/power thereto.Such arrangement facilitates transfer of electrical power/signalsbetween the housing and the surgical end effector 10200′ whilefacilitating articulation and rotation of the surgical end effector10200′ relative to the proximal shaft segment 10100.

FIGS. 50 and 51 illustrate another surgical instrument 10000″ thatcomprises a surgical end effector 10200″. In certain instances, surgicalend effector 10200″ is identical to surgical end effector 10200 exceptfor the differences discussed below. The surgical end effector 10200″comprises an end effector frame assembly 10210″ that comprises a distalframe member 10720″. The distal frame member 10720″ includes aproximally-extending proximal end portion 10722″ that is rotatablysupported within a bore 10231″ in a proximal frame housing 10230″. Aplurality of recesses 10726″ are provided in a proximal end of theproximal end portion 10722″. In various instances, the recesses 10726″are adapted to be engaged by a flexible unlocking cable or unlocking rod10342″ in the various manners described herein. See FIG. 50.

Still referring to FIGS. 50 and 51, the surgical end effector comprisesa first jaw 10250 and a second jaw 10270. The first jaw 10250 ispivotally pinned to the distal frame member 10720″ for selective pivotaltravel relative thereto about a first jaw axis FJA defined by a firstjaw pin 10221. The second jaw 10270 is pivotally pinned to the first jaw10250 for selective pivotal travel relative to the first jaw 10250 abouta second jaw axis SJA that is defined by a second jaw pin 10271. Incertain instances, the surgical end effector 10200″ employs an actuatoryoke assembly 10710″ that differs in some aspects from actuator yokeassembly 10610. In the illustrated example, the actuator yoke assembly10710″ is pivotally coupled to the second jaw 10270 by a second jawattachment pin 10274. The first jaw 10250 comprises a cam surface 10252that is configured to cammingly interact with the actuator yoke assembly10710″ when the actuator yoke assembly 10710″ is driven distally to camthe first jaw 10250 into an open position about the first jaw pin 10221.

The surgical instrument 10000″ comprises an end effector drive member10600″. In certain instances, the end effector drive member 10600″comprises a flexible rotary shaft 10602″ that is capable of rotationwhile being able to bend and flex to accommodate articulation of thesurgical end effector 10200″ in the manners described herein. In variousinstances, the flexible rotary shaft 10602″ operably interfaces with amotor or other source of rotary motion supported in a housing, forexample. As can be see in FIGS. 50 and 51, a threaded nut 10730″ isfixedly attached to the flexible rotary drive shaft 10602″. The threadednut 10730″ is threadably received within a threaded bore 10729″ in thedistal frame member 10720″ for rotatable threaded travel therein. Thethreaded nut 10730″ is also attached to the actuator yoke assembly10710″ to permit relative rotation therebetween. For example, a distallyprotruding rotary hub 10732″ is formed on the threaded nut 10730″ and isrotatably received within a bore 10711″ in the actuator yoke assembly10710″. The rotary hub 10732″ may be rotatably retained within the bore10711″ by a split ring 10713″ or other retention feature.

In certain instances, the first and second jaws 10250, 10270 are openedand closed as follows. To open and close the jaws 10250, 10270, theunlocking cable or unlocking rod 10342″ must be in locking engagementwith a corresponding one of the recesses 10726″ in the proximal end ofthe proximal end portion 10722″ to prevent rotation thereof. See FIG.50. As was discussed above, in certain instances, the unlocking cable orunlocking rod 10342″ may be biased in the locked position by a spring orother biasing arrangement. When the unlocking cable or unlocking rod10342″ is in the locked position, rotation of the rotary drive shaft10602″ in a first direction will rotate the threaded nut 10730″ withinthe threaded bore 10729″ in the distal frame member 10720″ and drive theactuator yoke assembly 10710″ in the distal direction DD. Because theunlocking cable or unlocking rod 10342″ is in locking engagement withthe proximal end portion 10729″ of the distal frame member 10720″, thesurgical end effector 10200″ is prevented from rotating about the shaftaxis SA when the rotary drive shaft 10602″ is rotated. Rotation of therotary drive shaft 10602″ will axially drive the actuator yoke assembly10710″ distally and cause the jaws 10250, 10270 to pivot towards an openposition. Rotation of the rotary drive shaft 10602″ in a seconddirection opposite the first direction will axially drive the actuatoryoke assembly 10710″ proximally and pull the jaws 10250, 10270 toward aclosed position.

To rotate the surgical end effector 10200″ about the shaft axis SA, theunlocking cable or unlocking rod 10342″ is pulled proximally to therebydisengage from the corresponding recess 10726″ in the proximal endportion 10729″ of the distal frame member 10720″. Thereafter, the rotarydrive shaft 10602″ is rotated in a desired direction. In such instance,there is enough friction between the threaded nut 10730″ and theinternal threads 10729″ in the distal frame member 10720″ such thatrotation of the threaded nut 10730″ will cause the distal frame member10720″ (and the surgical end effector 10200″) to rotate about the shaftaxis SA.

FIGS. 52-54 illustrate another surgical instrument 11000 that comprisesa surgical end effector 11200 that is coupled to a proximal shaftsegment 10100 by an articulation joint 10300 in the various mannersdescribed herein. In certain instances, a flexible cover 10301 may beprovided over the articulation joint 10300 to prevent fluids and debrisfrom hampering operation of the articulation joint 10300. As can also beseen in FIG. 52, such arrangement may facilitate articulation of thesurgical end effector 11200 relative to the shaft axis SA through anarticulation angle AL. In at least one arrangement, for example, thearticulation angle AL may be slightly less than 50 degrees.

In certain instances, the surgical end effector 11200 comprises an endeffector frame assembly 11210 that comprises a distal frame member 11220that is rotatably supported in a proximal frame housing 11230 that isfixedly attached to the proximal end effector frame member 10320. Forexample, the proximal frame housing 11230 may be attached to theproximal end effector frame member 10320 by welding, adhesive, etc. Invarious instances, the distal frame member 11220 is rotatably attachedto the proximal frame housing 11230 by an annular rib 11221 on thedistal frame member 11220 that is received within an annular groove11231 in the proximal frame housing 11230.

In various instances, the surgical instrument 11000 further comprises anend effector locking system 11225 that comprises a plurality of radialgrooves or recesses 11226 that are formed in the distal frame member11220. The locking system 11225 further comprises a lock insert 11340that is adapted to lockingly engage the radial grooves 11226 in thedistal frame member 11220. The lock insert 11340 is coupled to anunlocking cable or rod 11342 that extends through the articulation joint10300 and is flexible to accommodate articulation of the surgical endeffector 11200. As was discussed herein, the unlocking cable 11342operably interfaces with a motor or other control system in the housingto pull the unlocking cable or unlocking rod 11342 in the proximaldirection. A locking spring 11343 serves to bias the lock insert 11340into locking engagement with the grooves 11226 in the distal framemember 11220 to prevent the distal frame member 11220 (and surgical endeffector 11200) from rotating about the shaft axis SA.

In one example, a first jaw 11250 is pivotally pinned to the distalframe member 11220 for selective pivotal travel relative thereto about afirst jaw axis FJA defined by a first jaw pin 11221. A second jaw 11270is pivotally pinned to the first jaw 11250 for selective pivotal travelrelative to the first jaw 11250 about a second jaw axis SJA that isdefined by a second jaw pin 11272. In the illustrated example, thesurgical end effector 11200 employs actuator yoke assembly 11610 that ispivotally coupled to the second jaw 11270 by a second jaw attachment pin11273 for pivotal travel about a jaw actuation axis JAA that is proximaland parallel to the first jaw axis FJA and the second jaw axis SJA. Theactuator yoke assembly 11610 is coupled to a threaded member 11630. Inthe illustrated example, the threaded member 11630 essentially comprisesa worm gear 11632 that is configured to threadably engage correspondingthreads in a threaded bore 11229 in the distal frame member 11220. Asthe threaded member 11630 is rotated about the shaft axis SA, the wormgear 11632 also causes the threaded member 11630 to translate axially.

The surgical instrument 11000 comprises an end effector drive member11600. In at least one arrangement, an end effector drive member 11600comprises a flexible rotary shaft 11602 that is capable of rotationwhile being able to bend and flex to accommodate articulation of thesurgical end effector 11200 in the manners described herein. In certaininstances, the flexible rotary shaft 11602 may operably interface with amotor or other source of rotary motion supported in a housing andcomprises a laser-cut hollow tube that is capable of flexing or bendingto accommodate articulation of the surgical end effector 11200. A distalend 11604 of the flexible rotary drive shaft 11602 has diametricallyopposed slots 11606 formed therein. The slots 11606 are each configuredto receive therein a corresponding fin 11636 that is formed on aproximally extending hub 11634 on the threaded member 11630. Sucharrangement permits the flexible rotary shaft 11602 to convey rotarycontrol motions to the threaded member 11630 while permitting thethreaded member 11630 to translate axially relative to the distal end11604 of the flexible rotary shaft 11602.

In certain instances, the first and second jaws 11250, 11270 are openedand closed as follows. To open and close the jaws, as was discussed indetail above, the lock insert 11340 is in locking engagement with acorresponding radial groove 11226 in the distal frame member 11220 toprevent rotation of the end effector 11200 about the shaft axis SA.Thereafter, rotation of the rotary drive shaft 11602 in a firstdirection will rotate the threaded member 11630 within the threaded boreor passage 11229 in the distal frame member 11220 and drive the actuatoryoke assembly 11610 in the distal direction DD to move the first jaw11250 and the second jaw 11270 toward an open position. Because the lockinsert 11340 is in locking engagement with the distal frame member11220, the surgical end effector 11200 is prevented from rotating aboutthe shaft axis SA when the rotary flexible drive shaft 110602 isrotated. Rotation of the rotary drive shaft 11602 in a second directionopposite the first direction will axially drive the actuator yokeassembly 11610 proximally and pull the jaws 11250, 11270 toward a closedposition.

In various instances, to rotate the surgical end effector 11200 aboutthe shaft axis SA, the unlocking cable 11342 is pulled proximally tocause the lock insert 11340 to disengage the lock grooves 11226 in thedistal frame member 11220. Thereafter, the flexible rotary drive shaft11602 is rotated in a desired direction which will cause the distalframe member 11220 (and the surgical end effector 11200) to rotate aboutthe shaft axis SA.

FIG. 55 illustrates another surgical instrument 12000 that comprises asurgical end effector 12200 that may be coupled to a proximal shaftsegment 10100 by an articulation joint 10300 in the various mannersdescribed herein. In certain instances, the surgical end effector 12200comprises an end effector frame assembly 12210 that comprises a distalframe member 12220 that is rotatably supported in a proximal framehousing (not shown) that is attached to the articulation joint (notshown).

The surgical end effector 12200 comprises a first jaw 12250 and a secondjaw 12270. In the illustrated example, the first jaw 12250 is pivotallypinned to the distal frame member 12220 for selective pivotal travelrelative thereto about a first jaw axis FJA defined by a first jaw pin12221. The second jaw 12270 is pivotally pinned to the first jaw 12250for selective pivotal travel relative to the first jaw 12250 about asecond jaw axis SJA that is defined by a second jaw pin 12272. In theillustrated example, the surgical end effector 12200 employs an actuatoryoke assembly 12610 that is pivotally coupled to the second jaw 12270 bya second jaw attachment pin 12273 for pivotal travel about a jawactuation axis JAA that is proximal and parallel to the first jaw axisFJA and the second jaw axis SJA. The actuator yoke assembly 12610comprises a proximal threaded drive shaft 12614 that is threadablyreceived in a threaded bore 12632 in a distal lock plate 12630. Thethreaded drive shaft 12614 is mounted to the actuator yoke assembly12610 for relative rotation therebetween. The distal lock plate 12630 issupported for rotational travel within the distal frame member 12220.Thus rotation of the distal lock plate 12630 will result in the axialtravel of the actuator yoke assembly 12610.

In certain instances, the distal lock plate 12630 comprises a portion ofan end effector locking system 12225. The end effector locking system12225 further comprises a dual-acting rotary lock head 12640 that isattached to a rotary drive shaft 12602 of the various types disclosedherein. The lock head 12640 comprises a first plurality of radiallyarranged distal lock features 12642 that are adapted to lockingly engagea plurality of proximally-facing, radial grooves or recesses 12634 thatare formed in the distal lock plate 12630. When the distal lock features12642 are in locking engagement with the radial grooves 12634 in thedistal lock plate 12630, rotation of the rotary lock head 12640 willcause the distal lock plate 12630 to rotate within the distal framemember 12220. Also in at least one example, the rotary lock head 12640further comprises a second series of proximally-facing proximal lockfeatures 12644 that are adapted to lockingly engage a correspondingseries of lock grooves (not shown) that are provided in the distal framemember 12220. A locking spring 12646 serves to bias the rotary lock headdistally into locking engagement with the distal lock plate 12630. Invarious instances, the rotary lock head 12640 may be pulled proximallyby an unlocking cable or other member (not shown) in the mannerdescribed herein. In another arrangement, the rotary drive shaft 12602may be configured to also move axially to move the rotary lock head12640 axially within the distal frame member 12220. When the proximallock features 12644 in the rotary lock head 12640 are in lockingengagement with the series of lock grooves in the distal frame member12220, rotation of the rotary drive shaft 12602 will result in rotationof the surgical end effector 12200 about the shaft axis SA.

In certain instances, the first and second jaws 12250, 12270 are openedand closed as follows. To open and close the jaws, as was discussed indetail above, the rotary lock head 12640 is in locking engagement withthe distal lock plate 12630. Thereafter, rotation of the rotary driveshaft 12602 in a first direction will rotate the distal lock plate 12630which will axially drive the actuator yoke assembly 12610 in the distaldirection DD and move the first jaw 12250 and the second jaw 12270toward an open position. Rotation of the rotary drive shaft 12602 in anopposite second direction will axially drive the actuator yoke assembly12610 proximally and pull the jaws 12250, 12270 toward a closedposition. To rotate the surgical end effector 12200 about the shaft axisSA, the locking cable or member is pulled proximally to cause the rotarylock head 12640 to disengage from the distal lock plate 12630 and engagethe distal frame member 12220. Thereafter, when the rotary drive shaft12602 is rotated in a desired direction, the distal frame member 12220(and the surgical end effector 12200) will rotate about the shaft axisSA.

FIGS. 56-67 illustrate another surgical instrument 13000 that comprisesa surgical end effector 13200 that may be coupled to a proximal shaftsegment 10100 by an articulation joint 10300 in the various mannersdescribed herein. In certain instances, the surgical end effector 13200comprises an end effector frame assembly 13210 that defines an endeffector axis EA. As can be seen in FIGS. 57 and 58, the articulationjoint 10300 may facilitate selective articulation of the surgical endeffector 13200 relative to the shaft axis SA through an articulationangle AL on each side of the shaft axis SA. In various instances, thearticulation angle AL may be approximately sixty degrees, for example.

Turning to FIGS. 59 and 60, in certain instances, the end effector frameassembly 13210 comprises a distal frame member 13220 and a distalretainer assembly 13700. In the illustrated example, a first jaw 13250is pivotally pinned to the distal frame member 13220 for selectivepivotal travel relative thereto about a first jaw axis FJA. See FIG. 60.A second jaw 13270 is pivotally pinned to the first jaw 13250 forselective pivotal travel relative to the first jaw 13250 about a secondjaw axis SJA. See FIG. 59. In various instances, the surgical endeffector 13200 employs actuator yoke assembly 13610 that is pivotallycoupled to the second jaw 13270 by a second jaw attachment pin 13273 forpivotal travel about a jaw actuation axis JAA that is proximal andparallel to the first jaw axis FJA and the second jaw axis SJA. Theactuator yoke assembly 13610 is coupled to a threaded nut member 13630for relative rotation therebetween. For example, as can be seen in FIGS.59 and 60, the threaded nut member 13630 comprises a retainer head 13632that is rotatable received in a cavity 13612 in the actuator yokeassembly 13610. Such arrangement permits the threaded nut member 13630to rotate without rotating the actuator yoke assembly 13610. Thethreaded nut member 13630 further includes a threaded segment 13634 thatis threadably received within a threaded passage 13222 in the distalframe member 13220. A flexible rotary drive shaft 13602 is attached tothe threaded nut member 13630.

In certain instances, the distal frame member 13220 further includes aproximally protruding central axle portion 13226. The central axleportion 13226 is hollow to facilitate rotary passage of the rotary driveshaft 13602 therethrough. The central axle portion 13226 is rotatablysupported within the distal retainer assembly 13700 by a bushing 13710.The distal retainer assembly 13700 is supported on a proximal hubportion 13228 of the distal frame member 13220. See FIG. 60. A frictionring 13704 is journaled on the proximal hub portion 13228 between theproximal hub portion 13228 and the distal retainer assembly 13700. Anend effector housing member 13706 extends over the distal retainerassembly 13700 and is attached by welding, adhesive, press fit, etc. toa portion of the distal frame member 13220. In various instances, aproximal end of the distal retainer assembly 13700 comprises a pair ofupstanding support arms 13702 that are pivotally coupled to the proximalshaft frame member 10310 to facilitate articulation of the surgical endeffector 13200 about the articulation axis in various manners describedherein.

In at least one arrangement, the surgical end effector 13200 furthercomprises an end effector locking system 13730 that includes a distallock member 13732 that is supported for axial and non-rotationalmovement on the central axial portion 13226 of the distal frame member13220. Thus, the distal lock member 13732 is axially movable between alocked position and an unlocked position on the central axial portion13226 but rotates with the central axial portion 13226. The distal lockmember 13732 comprises a plurality of proximally extending lock features13734 that are configured to lockingly engage corresponding lock grooves(not shown) in the distal retainer assembly 13700 when the distal lockmember 13732 is in a locked position. An unlocking spring 13736 isprovided to bias the distal lock member 13732 distally into the unlockedposition. The distal lock member 13732 is selectively movable from theunlocked position to the locked position by a locking cable or lockingmember 13738 that extends through the proximal shaft segment 10100 tothe housing. When the locking cable or locking member 13738 is pulledproximally, the distal locking member 13732 is moved proximally into thelocked position. In the illustrated arrangement, the distal lockingmember 13732 is hollow such that the rotary drive shaft 13602 may extendtherethrough. The distal locking member 13732 is axially movable and therotary drive shaft 13602 is rotatable within the distal locking member13732.

In certain instances, the first and second jaws 13250, 13270 are openedand closed as follows. To open and close the jaws, the distal lockingmember 13732 is moved into the locked position by pulling the lockingcable or locking member 13738 in the proximal direction. Thereafter,rotation of the rotary drive shaft 13602 in a first direction willrotate the threaded nut member 13630 which will axially drive theactuator yoke assembly 13610 in the distal direction to move the firstjaw 13250 and the second jaw 13270 toward an open position. Rotation ofthe rotary drive shaft 13602 in a second direction opposite the firstdirection will axially drive the actuator yoke assembly 13610 proximallyand pull the jaws 13250, 13270 toward a closed position. To rotate thesurgical end effector 13200 about the shaft axis SA, the locking cableor locking member 13738 is released to permit the distal locking member13732 to be biased distally by the spring 13736 into an unlockedposition. Thereafter, the rotary drive shaft 13602 is rotated in adesired direction which will cause the distal frame member 13220 (andthe surgical end effector 13200) to rotate about the shaft axis SA.

As indicated above, the surgical instrument 13000 may comprise anarticulation joint 10300 that is controlled by an articulation system10400. In various instances, the articulation system 10400 employs arotary driven articulation actuator 13470 that is configured to applyarticulation motions to the right proximal link 10410 and the leftproximal link 10430 upon application of rotary articulation controlmotions thereto. See FIG. 62. In the illustrated arrangement, thearticulation actuator 13470 comprises a distal articulation shaft 13472that includes a distal end formation 13474 that is pivotally coupled tothe right proximal link 10410 and the left proximal link 10430 in theabove described manner. As can be seen in FIGS. 62-65, the distalarticulation shaft 13472 further comprises an axial articulation drivemember 13476 that is threadably received in a threaded passage 13482 ina rotatable articulation driver 13480. See FIG. 63. The rotatablearticulation driver 13480 further includes a ball-shaped support feature13484 that rotatably supports the rotatable articulation driver 13480within the proximal shaft segment 10100 while also facilitating limitedoff-axis tilting of the articulation driver 13480 during articulation ofthe surgical end effector 13200.

The rotatable articulation driver is 13480 rotatably supported within aproximal shaft frame member 10310′ that is supported within a proximalouter shaft tube 10110 that may extend from the housing or otherwiseinterface therewith. In the illustrated example, for assembly purposes,the proximal shaft frame member 10310′ comprises a right proximal framesegment 13312 and a left proximal frame segment 13314. A rotaryarticulation drive shaft or cable 13490 is attached to the rotatablearticulation driver 13480 and is configured to receive rotaryarticulation control motions from an articulation motor or other controlarrangement supported by the housing.

FIG. 63 is a side cross-sectional view of the articulation joint 10300in an unarticulated position. As can be seen in FIG. 63, when thearticulation joint 10300 is in an unarticulated position, anarticulation drive shaft axis ADA is approximately parallel to the shaftaxis SA. FIG. 64 illustrates the articulation joint 10300 articulated tothe right approximately sixty degrees. In such instance, the rotaryarticulation drive shaft or cable 13490 is rotated in a first rotarydirection. As can be seen in FIG. 64, the rotatable articulation driver13480 can assume a first angle FAA₁ relative to the articulation driveshaft axis ADA to accommodate articulation of the surgical end effector13200 through a full range of articulation to the right of the shaftaxis SA. In one example, the surgical end effector may be articulatablethrough an angle of approximately sixty degrees on the right side of theshaft axis SA. FIG. 65 illustrates the articulation joint 10300articulated to the left. In such instance, the rotary articulation driveshaft or cable 13490 is rotated in a second rotary direction oppositethe first rotary direction. As can be seen in FIG. 65, the rotatablearticulation driver 13480 can also assume a second angle SAA₂ relativeto the articulation drive axis ADA to accommodate articulation of thesurgical end effector 13200 through a full range of articulation to theleft of the shaft axis SA. In one example, the full range ofarticulation may be through an angle of approximately sixty degrees on aleft side of the shaft axis SA.

In certain instance, to facilitate transfer of electric signals/powerbetween the housing and the surgical end effector 13200 and moreparticularly to one or both of the first and second jaws, a flexiblecircuit 10940 (FIGS. 66, 67) may be provided through the proximal shaftsegment 10100 and span the articulation joint 10300. In variousinstances, as can be seen in FIGS. 66 and 67, the flexible circuit 10940comprises a left contact end 10942 that may be fixed to the distalretainer assembly 13700 by adhesive for example. The flexible circuit10940 may further include a right spiral portion 10944. An end 10946 ofthe right spiral portion 10944 is attached to the axle portion 13226 ofthe distal frame member 13220 by adhesive for example. The end 10946 maycomprise or be coupled to a distally extending flexible circuit 10948that is supported in the distal frame member 13220 and coupled to thefirst and second jaws (not shown). Such an arrangement may permit thedistal frame member 13220 to rotate through a path of 180 degrees ineither direction about the shaft axis SA before the right spiral portion10944 runs out of length.

In certain instances, the surgical end effector 13200 employs curvedjaws 13250 and 13270 that are designed to facilitate better access toand manipulation of tissue. For example, FIG. 68 illustrates a first jaw13250 that comprises a first jaw body 13251 that defines a first jawclamping face 13252. The first jaw body 13251 further comprises a firstproximal end 13253 and a first distal tip 13254. In various instances,the first jaw 13250 defines a first jaw center axis FJCA₁ and, as can beseen in FIG. 68, the first distal tip 13254 is laterally displaced to afirst side 13255 of the first jaw center axis FJCA₁. In one example, thefirst jaw 13250 supports a first monopolar electrode 13290 and a firstbipolar electrode 13291.

In various instances, the second jaw 13270 comprises a second jaw body13271 that defines a second jaw clamping face 13272. In one example, theportion of the second jaw body 13271 that defines the second clampingface 13272 may essentially comprise a mirror image of the portion of thefirst jaw body 13251 that defines the first jaw clamping face 13252. Incertain instances, the second jaw body 13271 further comprises a secondproximal end 13273 and a second distal tip 13274. The second jaw 13270defines a second jaw center axis SJCA₂ and, as can be seen in FIG. 69,the second distal tip 13274 is laterally displaced to a first side 13275of the end second jaw center axis SJCA₂. In the illustrated example, thesecond jaw 13270 supports a second bipolar electrode 13292.

In various instances, in use, when the first jaw 113250 and the secondjaw 13270 are moved from an open position to a fully closed positionwithout clamping onto tissue, the first jaw 13250 and the second jaw13270 will be approximately perfectly aligned with each other. When inthat position, for example, the first jaw center axis FJCA₁ and thesecond and the second jaw center axis SJCA₂ will both lie on a commonplane. The second distal tip 13274 will be aligned with the first distaltip 13254. When the first jaw 13250 and the second jaw 13270 are clampedonto tissue, the tissue may tend to skew portions of the first jaw 13250and the second jaw 13270 out of alignment. This misalignment may be thegreatest at the distal tips of the jaws. Such misalignment of the jawsmay increase distal to the jaw mid point MP. For example, because thedistal tips 13254 and 13274 are laterally displaced (curved) from thejaw center axes FJCA₁ and SJCA₂, the distal tips 13254, 13274 aresusceptible to further misalignment as the jaws 13254, 13274 continue toclamp down on or close down on tissue. This misalignment is generallyundesirable.

FIG. 70 comprises a cross-sectional end view of the first jaw 13250 andthe second jaw 13270 during closure (without tissue) wherein the firstjaw 13250 and the second jaw 13270 are vertically aligned. Duringclamping of the jaws 13250, 13270 onto tissue T, the jaws 13250, 13270may tend to splay laterally and become misaligned (FIG. 71). Thismisalignment may begin or at least increase in the portions of the jawsthat are distal to the jaw midpoints MP. Such undesirable occurrence mayresult in the formation of an RF short. FIGS. 72 and 73 representdiagrammatical depictions of a clamping force F_(C) and the resultingamount of biasing force F_(B) experienced by the jaws 13250, 13270 whichtends to skew the jaws and move them out of alignment. An amount of jawclamping force F_(C) (lbs.) necessarily increases as the jaws are movedfrom an open position to a fully closed or clamped position on a targettissue. As the jaws 13250, 13270 are moved toward each other in theclosing direction, the amount of misalignment forces experienced by thejaws tends to increase due to the resistance of the tissue. FIG. 75 is agraphical comparison of the jaw clamping force F_(C) vs. the amount offorce required to realign the jaws (jaw biasing force F_(B)) during thejaw closure process.

In certain instances, at least one of the jaws 13250,13270 comprises atleast one alignment feature that is configured to engage a correspondingportion of the other jaw to bring the jaws into “axial alignment” witheach other during closing. As used herein, the term “axial alignment”means that a centerline of one jaw is generally axially aligned with acenterline of the other jaw during closing. Further, when the seconddistal tip 13274 is “aligned with” the first distal tip 13254, the outerperimeter of the second jaw clamping face 13272 is generally alignedwith the outer perimeter of the first jaw clamping face 13252 when fullyclosed or fully clamped on tissue. In another arrangement, when thesecond distal tip 13274 is “aligned with” the first distal tip 13254, noportion of the first jaw clamping face 13252 extends laterally beyondthe second jaw clamping face 13272 when the jaws 13250, 13270 are fullyclosed or fully clamped on tissue. This definition of “aligned with” isof course applicable to jaws 13250, 13270 that have an identical sizeand outer shape. If, for example, one of the jaws has a protrusion orformation that extends from an outer surface of the jaw and theprotrusion is not found on the corresponding surface of the other jaw,but the jaw with the protrusion is otherwise identical in shape to theother jaw (except for, perhaps, the clamping faces of the jaws), thosejaws may be aligned with each other when the centerlines of the jawsline on a common plane. Thus, another definition of “aligned with” inthe context of the second jaw 13270 being aligned with the first jaw13250 may consist of the first jaw 13250 and the second jaw 13270 beingaligned with each other such that the first jaw center axis FJCA₁ andthe second jaw center axis SJCA₂ lie along a common alignment plane AP.See FIG. 70.

In an illustrated example, the first jaw 13250 and the second jaw 13270each have a toothed surface that comprises a series of radially alignedteeth. FIG. 77 depicts a plurality of first alignment features thatcomprise “radially aligned” first teeth 13256 formed on the first jawclamping face 13252. Similarly, the second jaw 13270 comprises aplurality of second alignment features that comprise radially alignedsecond teeth 13276 on the second jaw clamping face 13272. See FIG. 76.As used in this context, the term “radially aligned” means that eachtooth lies along a corresponding axis and each axis intersects a commonpoint that is laterally displaced from the center axis of the jaw.

FIG. 76 depicts a portion of the first jaw 13250 and a correspondingportion of the second jaw 13270 in cross-section. As can be seen in FIG.76, each first tooth 13256 has a first tooth tip 13257 and each firsttooth 13256 is separated by a first valley 13258. Similarly, the secondjaw 13270 has a second toothed surface 13274 that is configured to matewith the first toothed surface 13254 on the first jaw 13250. As can befurther seen in FIG. 76, each second tooth 13276 has a second tooth tip13277 and each second tooth 13276 is separated by a second valley 13278.In one arrangement the second tooth tip 13277 on each second tooth 13278is configured to be aligned with a corresponding first valley 13258 andeach first tooth tip 13257 is aligned with a corresponding second valley13278 when the first jaw 13250 and the second jaw 13270 are properlyaligned and moved to a closed position. In at least one arrangement, thesecond teeth 13276 are similarly radially aligned on the second jaw13270. In use, as the first jaw 13250 and the second jaw 13270 are movedtoward each other, at least some of the first tips 13257 and the secondtips 13277 eventually become engaged. In one arrangement, for example,the respective height of each first tooth 13256 and of each second tooth13257 are greater than an amount of tissue gap formed between the firstjaw clamping face 13252 and the second jaw clamping face 13272 that isnecessary to accommodate the electrodes 13290, 13291, 13292. Forexample, each of the first teeth tips 13257 (or at least some of them)extend beyond the first electrodes 13290, 13291 on the first jaw 13250.Likewise, each of the second teeth tips 13277 (or at least some of them)extend beyond the electrode 13292 on the second jaw 13270. As the jaws13250, 13270 continue to move toward each other, the interaction betweenat least some of the first teeth 13256 and at least some of thecorresponding second teeth 13276 serve to move the first distal tip13254 and the second distal tip 13274 into alignment. Although in theillustrated example, the first teeth 13256 occupy substantially theentire first jaw clamping face 13252 and the second teeth 13276 occupysubstantially the entire second jaw clamping face 13272, due to thecurved nature of the first jaw 13250 and the second jaw 13270, incertain instances, it is the interaction of at least some of the firstteeth 13256 and the corresponding second teeth 13276 that are distal tothe jaw midpoint MP that generally serve to bring the first distal tip13254 and the second distal tip 13274 into alignment duringclosing/clamping. This alignment progressively increases as the jawscontinue to clamp down onto the tissue. Stated another way, the biasingforces that serve to bring the jaws 13250, 13270 into alignment increaseas the jaw clamping or closure forces Fc increase.

In certain instances, the first teeth 13256 only encompass the portionsof the first jaw clamping face 13252 that are not occupied by either ofthe electrodes 13290, 13291. Those portions of the first jaw clampingface 13252 may comprise insulative material. Likewise, in such anembodiment, the second teeth 13276 only encompass the portions of thesecond jaw clamping face 13272 that are not occupied by the electrode13292. In other arrangements, the first teeth 13256 also extend over theconductive portions of the electrodes 13290, 13291 and the second teeth13276 also extend over the conductive portions of the electrode 13292.

In at least one example, each of the first jaw 13250 and the second jaw13270 include somewhat linear segments that cooperate to form a generalcurve such that the distal tips 13254, 13274 of each jaw are laterallydisplaced to a common side of the jaw center axes FJCA₁, SJCA₂. SeeFIGS. 68 and 69. FIG. 77 depicts a radial tooth arrangement that isaligned to the average greatest curvature of the jaws even if the jawsinclude straight portions. FIG. 78 illustrates an alternative first jawembodiment 13250′ that comprises a gentle curve that is formed withoutany linear segments/sidewalls.

FIGS. 79-81 illustrate a surgical end effector arrangement 13200′ thatcomprises a first jaw 13250′ and a second jaw 13270′. In certaininstances, the second jaw 13270′ comprises at least one, and preferablytwo, lateral alignment features 13280, 13282 that serve to laterallyengage a corresponding side of the first jaw 13250′ during clamping toalign the first and second jaws 13250′, 13270′ during the clampingprocess. In end effectors that are equipped with bipolar electrodes, thejaws may comprise multiple jaw features which interact within more thanone isolated zone in the jaws to cause a physical force to re-align themisaligned jaws and to re-align the electrode in the first jaw with theelectrode in the second jaw. In one arrangement, for example, the DLC ofthe first jaw/electrode set is offset laterally from the electrode inthe second jaw/electrode. However, the teeth of each jaw extend withinthe electrode portion and the insulated portion and the overlap is greatenough to allow the distal tips of the jaws to be initially misalignedby the tissue as the radially arrayed teeth begin to engage each other.In one arrangement for example, the insulative portion of the teeth ofthe first jaw engage the conductive portion of the teeth of the secondjaw forcibly realign the distal tips of the first and second jaws alongthe tooth profile.

In various arrangements, it may be advantageous to employ a surgical endeffector that has a jaw closure arrangement that provides fordistal-to-proximal jaw closure. For example, FIG. 82 depicts a surgicalend effector 14200 that includes a first jaw 14250 and a second jaw14270 that are movably coupled together in such a way as to induceinitial contact between the distal tips 14254 and 14274 of the first andsecond jaws 14250, 14270, respectively. Such arrangement may comprise anoffset pivot between the first jaw 14250 and the second jaw 14270 tocamber one of the jaws toward the other jaw. FIGS. 83 and 84 depict asurgical end effector 14200′ that includes a first jaw 14250′ and asecond jaw 14270′ that are movably coupled together. The first andsecond jaws 14250′, 14270′ progressively elastically deform as the jawsare clamped toward each other. A deflectable proximal operatingmechanism may be employed that allows the jaw's clamping load to beincreased while minimizing the jaw deflection and delivering uniformloading between the jaws. As illustrated in FIG. 84, the jaws 14250′,14270′ may establish a uniform pressure profile when fully clamped.

FIG. 85 illustrates another surgical instrument 15000 that comprises asurgical end effector 15200 that may be coupled to a proximal shaftsegment 10100 by an articulation joint 15300. In the illustratedarrangement, the articulation joint 15300 comprises a proximal shaftframe member 15310 that extends distally out of a distal end 10102 ofthe proximal shaft segment 10100. The proximal shaft frame member 15310may be attached to the proximal outer shaft tube 10110 by, for example,welding, adhesive, etc. In certain instances, the proximal shaft framemember 15310 comprises a U-shaped cradle portion that includes distallyextending attachment arms 15312, 15314, wherein attachment arm 15312 islocated on one side of the shaft axis SA and the attachment arm 15314 islocated on an opposite side of the shaft axis SA.

The articulation joint 15300 further comprises a proximal end effectorframe member 15320 that also comprises a portion of an end effectorframe assembly 15210. The proximal end effector frame member 15320comprises two upstanding support sides 15322, 15324 that define aU-shaped cradle 15326. The proximal end effector frame member 15320 isreceived between the attachment arms 15312, 15314 and is pivotallysupported therein by an articulation pin 15330 that defines anarticulation axis AA. The articulation joint 15300 facilitates selectivearticulation of the proximal end effector frame member 15320 throughranges of articulation on each side of the shaft axis SA. For example,the articulation joint 15300 facilitates articulation of the proximalend effector frame member 15320 from an unarticulated position to afirst maximum articulated position in a first articulation direction onone side of the shaft axis SA as well as to a second maximum articulatedposition in a second articulation direction on the opposite side of theshaft axis SA.

The surgical end effector 15200 is selectively articulated about thearticulation axis AA relative to the proximal shaft segment 10100 by anarticulation system generally designated as 15400. In the illustratedexample, the articulation system 15400 comprises a right proximal link15410 and a right distal link 15440 located on a right side of the shaftaxis SA, a left proximal link 15430 and a left distal link 15460 locatedon a left side of the shaft axis SA. The right proximal link 15410comprises a right proximal link body 15412 that is roughly L-shaped andcomprises a right proximal link proximal end (not shown) and a rightproximal link distal end 15416. Similarly, the left proximal link 15430comprises a left proximal link body 15432 that is roughly L-shaped andcomprises a left proximal link proximal end 15434 and a left proximallink distal end 15436. In the illustrated example, the right proximallink proximal end is pivotally supported relative to the attachment arm15312 and the left proximal link proximal end 15434 is pivotallysupported relative to the attachment arm 15314. The right proximal linkproximal end is pivotally coupled to the attachment arm 15312 and theleft proximal link proximal end 15434 is pivotally coupled to theattachment arm 15314 by a first link pin 15420. The first link pin 15420defines a first link axis FLA that is transverse to the shaft axis SAand facilitates pivotal travel of the right proximal link 15410 and theleft proximal link 15430 about the first link axis FLA relative to theproximal shaft frame member 15310.

In at least one arrangement, a proximal end of the right distal link15440 is pivotally pinned to the right proximal link distal end 10416. Adistal end of the right distal link 15440 is pivotally coupled to thesupport side 15322 of the effector frame member 15320. Similarly, aproximal end of the left distal link 15460 is pivotally pinned to theleft proximal link distal end 15436. A distal end of the left distallink 15460 is pivotally pinned to the upstanding support side 15324 ofthe end effector frame member 15320. The proximal end of the rightdistal link 15440 is pivotally coupled to the right proximal link distalend 15416 for pivotal travel about a third link axis TLA and theproximal end of the left distal link 15460 is pivotally coupled to theleft proximal link 15430 for pivotal travel about the third link axisTLA. The distal end of the right distal link 15440 is pinned to theupstanding support side 15322 of the end effector frame member 15320 forpivotal travel about a fourth link axis FRLA and the distal end of theleft distal link 15460 is pivotally pinned to the upstanding supportside 15324 of the end effector frame member 15320 for pivotal travelabout the fourth link axis FRLA.

In certain instances, the articulation system 15400 further comprises anaxially movable articulation actuator 15470 that is configured to applyaxial articulation motions to the right proximal link 15410 and the leftproximal link 15430. In the illustrated arrangement, the articulationactuator 15470 comprises a distal articulation shaft segment 15472 thatthreadably interfaces with an articulation drive nut 15480. Thearticulation drive 15480 comprises a threaded portion 15482 that isconfigured to rotate about an articulation drive axis ADA and a mountportion 15484 that is pivotally coupled to the proximal shaft framemember 15310. The mount portion 15484 facilitates pivotal travel of thearticulation drive 15480 about an articulation mount axis AMA that istransverse to the articulation drive axis ADA. A rotary driven proximalarticulation drive shaft 15490 is coupled to the threaded portion 15482of the mount portion 15480 such that the threaded portion 15482 isrotatable by the proximal articulation drive shaft 15490 relative to themount portion 15484. Rotation of the threaded portion 15482 results inaxial travel of the distal articulation shaft segment 15472.

In the illustrated example, the distal articulation shaft segment 15472includes a distal end formation 15474 that is pivotally coupled to theright proximal link 15410 and the left proximal link 15430 about thesecond link axis SLA. The surgical end effector 15200 may be selectivelyarticulated about the articulation axis AA by moving the distal endformation 15474 in a proximal direction PD or in a distal direction DD.The surgical instrument 15000 further includes a flexible rotary shaft10602 that is capable of rotation while being able to bend and flex toaccommodate articulation of the surgical end effector 15200 in themanners described herein. The flexible rotary shaft 10602 is configuredto open and close the jaws (not shown) of the surgical end effector15200 in the various manners disclosed herein. Likewise, rotation of theflexible rotary drive shaft 10602 will cause the surgical end effector15200 to rotate about the shaft axis SA in the various manners disclosedherein. FIGS. 88 and 89 comprise a finite element analysis of thecomponents of one form of articulation system 15300 described above.

FIGS. 89 and FIG. 90 depict another articulation system arrangement16300 that is configured to selectively articulate a surgical endeffector 16200. In this arrangement, the surgical end effector 16200 ispivotally coupled to a shaft (not shown) at an articulation point 16302for articulation relative thereto. The articulation system arrangement16300 comprises a right articulation member 16310 and a leftarticulation member 16320. The right articulation member 16320 ispivotally coupled to the surgical end effector 16200 and operablyinterfaces with an articulation drive arrangement in a housing (notshown) that is configured to apply axial articulation control motionsthereto. Likewise, the left articulation member 16320 is pivotallycoupled to the surgical end effector 16200 and operably interfaces withan articulation drive arrangement in a housing that is configured toapply axial articulation control motions thereto. FIG. 810 illustratesarticulation of the surgical end effector 16200 to the left wherein theright articulation member 16310 is axially advanced in the distaldirection DD and the left articulation member 16320 is axially advancedin the proximal direction PD.

FIG. 91 depicts another articulation system arrangement 17300 that isconfigured to selectively articulate a surgical end effector 17200. Inthis arrangement, the surgical end effector 17200 is pivotally coupledto a shaft (not shown) at an articulation point 17302 for articulationrelative thereto. The articulation system arrangement 17300 comprises awinch-style drive mechanism 17310 that includes a worm gear 17312 thatmeshingly interfaces with a worm wheel 17304 that is operably coupled tothe surgical end effector 17200. The winch-style drive mechanism 17310interfaces with a control system, motor, etc. operably supported in ahousing (not shown). Operation of the winch-style drive mechanism 17310will result in the articulation of the surgical end effector 17200 aboutthe articulation point 17302.

FIG. 92 depicts another articulation system arrangement 18300 that isconfigured to selectively articulate a surgical end effector 18200. Inthis arrangement, the surgical end effector 18200 is pivotally coupledto a shaft (not shown) at an articulation point 18302 for articulationrelative thereto. The articulation system arrangement 18300 comprises anarticulation drive member 18310 that comprises a threaded rod 18312 thatis attached to the surgical end effector 18200 by a ball and socketarrangement 18314. The threaded rod 18312 is in threaded engagement witha threaded nut 18320 fixedly supported in the shaft. The threaded rod18312 operably interfaces with an articulation drive arrangement in ahousing (not shown) that is configured to apply rotary articulationcontrol motions thereto. Rotation of the threaded rod 18312 appliesaxial articulation motions to the surgical end effector 18200 to pivotthe surgical end effector 18200 relative to the shaft assembly about thearticulation point 18302.

FIG. 93 depicts another articulation system arrangement 19300 that isconfigured to selectively articulate a surgical end effector 19200. Inthis arrangement, the surgical end effector 19200 is pivotally coupledto a shaft (not shown) at an articulation point 19302 for articulationrelative thereto. The articulation system arrangement 19300 comprises aclosed loop tungsten cable 19310 that is attached to the surgical endeffector 19200 at an attachment point 19312. Rotation of the cable 19310in a clockwise direction CW will result in articulation of the surgicalend effector 19200 in a right direction RD and rotation of the cable19310 in a counterclockwise direction CCW will result in articulation ofthe surgical end effector 19200 in a left direction LD. FIG. 94illustrates use of a spring 19330 to apply a counter force to the cable19310 to return the surgical end effector 19200 to an unarticulatedposition when articulation tension is relieved in the cable 19310.

Various aspects of the subject matter described herein are set out inthe following examples.

Example 1—A surgical instrument comprising a surgical end effector thatcomprises an end effector frame assembly. A proximal shaft segmentdefines a shaft axis and is attached to the end effector frame assemblyby an articulation system to facilitate articulation of the end effectorframe assembly relative to the proximal shaft segment about anarticulation axis that is transverse to the shaft axis. The articulationsystem comprises a first link that comprises a first link proximal endthat is pivotally coupled to the proximal shaft segment. The first linkfurther comprises a first link distal end. The articulation systemfurther comprises a second link that comprises a second link proximalend that is pivotally coupled to the first link distal end. The secondlink further comprises a second link distal end that is pivotallycoupled to the end effector frame assembly. The articulation systemfurther comprises an axially movable articulation actuator that operablyinterfaces with the first link at a location between the first linkproximal end and the first link distal end to apply articulation motionsthereto.

Example 2—The surgical instrument of Example 1, wherein the first linkcomprises a right proximal link that comprises a right proximal linkproximal end that is pivotally coupled to the proximal shaft segment ona right side of the shaft axis. The right proximal link furthercomprises a right proximal link distal end. The first link furthercomprises a left proximal link that comprises a left proximal linkproximal end that is pivotally coupled to the proximal shaft segment ona left side of the shaft axis. The left proximal link further comprisesa left proximal link distal end. The second link proximal end ispivotally coupled to the right proximal link distal end and the leftproximal link distal end. The axially movable articulation actuatoroperably interfaces with the right proximal link at a right pivotlocation on the right proximal link between the right proximal linkproximal end and the right proximal link distal end. The axially movablearticulation actuator operably interfaces with the left proximal link ata left pivot location on the left proximal link between the leftproximal link proximal end and the left proximal link distal end.

Example 3—The surgical instrument of Example 2, wherein the axiallymovably articulation actuator pivotally interfaces with the rightproximal link at the right pivot location, and wherein the axiallymovable articulation actuator pivotally interfaces with the leftproximal link at the left pivot location.

Example 4—The surgical instrument of Examples 2, or 3, wherein thesecond link proximal end is pivotally coupled to the right proximal linkdistal end and the left proximal link distal end.

Example 5—The surgical instrument of Examples 2, 3 or 4, wherein thesecond link proximal end spans transversely across the shaft axis and ispivotally coupled to the right proximal link distal end and the leftproximal link distal end.

Example 6—The surgical instrument of Examples 2, 3, 4 or 5, wherein thesecond link proximal end is centrally disposed between the rightproximal link distal end and the left proximal link distal end.

Example 7—The surgical instrument of Examples 2, 3, 4, 5 or 6, furthercomprising a drive member that extends between the right proximal linkand the left proximal link to apply a drive motion to the surgical endeffector.

Example 8—The surgical instrument of Example 7, wherein the drive motioncomprises a rotary drive motion.

Example 9—The surgical instrument of Example 7, wherein the drive motioncomprises an axial drive motion.

Example 10—The surgical instrument of Example 7, wherein the drivemotion comprises a first rotary drive motion and a second axial drivemotion.

Example 11—The surgical instrument of Examples 7, 8, 9 or 10, whereinthe drive member comprises a flexible shaft assembly.

Example 12—The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8,9, 10 or 11, wherein the surgical end effector further comprises a firstjaw that is pivotally supported on the end effector frame assembly and asecond jaw that is pivotally supported relative to the first jaw. Thefirst jaw and the second jaw are pivotable relative to each otherbetween an open position and a closed position upon axial controlmotions applied to one of the first jaw and the second jaw.

Example 13—The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8,9, 10, 11 or 12, wherein the second link is U-shaped.

Example 14—The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8,9, 10, 11, 12 or 13, wherein the second link distal end comprises a leftsecond link arm that is coupled to the second link proximal end and aright second link arm that is coupled to the second link proximal end.The left second link arm is spaced from the right second link arm andwherein the left second link arm and the right second link arm arepivotally coupled to the end effector frame assembly by an end effectorlink pin.

Example 15—A surgical instrument comprising a surgical end effector thatcomprises an end effector frame assembly. A first jaw is pivotallycoupled to the end effector frame assembly. A second jaw is pivotallycoupled to the first jaw, wherein the first jaw and the second jaw arepivotally movable between an open position and a closed position uponapplication of axial control motions to the second jaw. The surgicalinstrument further comprises a proximal shaft segment that defines ashaft axis, wherein the proximal shaft segment is attached to the endeffector frame assembly by an articulation system to facilitatearticulation of the end effector frame assembly relative to the proximalshaft segment about an articulation axis that is transverse to the shaftaxis. The articulation system comprises a first link that comprises afirst link proximal end that is pivotally coupled to the proximal shaftsegment. The first link further comprises a first link distal end. Thearticulation system further comprises a second link that comprises asecond link proximal end that is pivotally coupled to the first linkdistal end. The second link further comprises a second link distal endthat is pivotally coupled to the end effector frame assembly. Thearticulation system further comprises an axially movable articulationactuator that operably interfaces with the first link at a locationbetween the first link proximal end and the first link distal end toapply articulation motions thereto. The surgical instrument furthercomprises a drive member that extends between the right proximal linkand the left proximal link. The drive member is coupled to the secondjaw to apply the axial control motions thereto.

Example 16—The surgical instrument of Example 15, wherein the secondlink is U-shaped.

Example 17—The surgical instrument of Examples 15 or 16, wherein theproximal shaft segment comprises a proximal outer shaft tube thatdefines an outer diameter and a proximal retainer member that protrudesdistally from a distal end of the proximal outer shaft tube and ispivotally coupled to the end effector frame assembly to facilitatearticulation of the end effector frame assembly relative to the proximalretainer member about the articulation axis and wherein the first linkproximal end is pivotally coupled to the proximal retainer member.

Example 18—The surgical instrument of Example 17, wherein the first linkcomprises a right proximal link that comprises a right proximal linkproximal end that is pivotally coupled to the proximal retainer memberon a right side of the shaft axis and a right proximal link distal end.The first link further comprises a left proximal link that comprises aleft proximal link proximal end that is pivotally coupled to theproximal retainer member on a left side of the shaft axis and a leftproximal link distal end. The second link proximal end is pivotallycoupled to the right proximal link distal end and the left proximal linkdistal end. The axially movable articulation actuator operablyinterfaces with the right proximal link at a right pivot location on theright proximal link between the right proximal link proximal end and theright proximal link distal end. The axially movable articulationactuator operably interfaces with the left proximal link at a left pivotlocation on the left link between the left proximal link proximal endand the left proximal link distal end.

Example 19—The surgical instrument of Example 18, wherein the rightproximal link and the left proximal link do not extend outward beyondthe outer diameter of the proximal outer shaft tube.

Example 20—The surgical instrument of Examples 18 or 19, wherein theright proximal link defines a right radiused outer surface locatedbetween the right proximal link proximal end and the right proximal linkdistal end. The left proximal link defines a left radiused outer surfacelocated between the left proximal link proximal end and the leftproximal link distal end.

While several forms have been illustrated and described, it is not theintention of Applicant to restrict or limit the scope of the appendedclaims to such detail. Numerous modifications, variations, changes,substitutions, combinations, and equivalents to those forms may beimplemented and will occur to those skilled in the art without departingfrom the scope of the present disclosure. Moreover, the structure ofeach element associated with the described forms can be alternativelydescribed as a means for providing the function performed by theelement. Also, where materials are disclosed for certain components,other materials may be used. It is therefore to be understood that theforegoing description and the appended claims are intended to cover allsuch modifications, combinations, and variations as falling within thescope of the disclosed forms. The appended claims are intended to coverall such modifications, variations, changes, substitutions,modifications, and equivalents.

The foregoing detailed description has set forth various forms of thedevices and/or processes via the use of block diagrams, flowcharts,and/or examples. Insofar as such block diagrams, flowcharts, and/orexamples contain one or more functions and/or operations, it will beunderstood by those within the art that each function and/or operationwithin such block diagrams, flowcharts, and/or examples can beimplemented, individually and/or collectively, by a wide range ofhardware, software, firmware, or virtually any combination thereof.Those skilled in the art will recognize that some aspects of the formsdisclosed herein, in whole or in part, can be equivalently implementedin integrated circuits, as one or more computer programs running on oneor more computers (e.g., as one or more programs running on one or morecomputer systems), as one or more programs running on one or moreprocessors (e.g., as one or more programs running on one or moremicroprocessors), as firmware, or as virtually any combination thereof,and that designing the circuitry and/or writing the code for thesoftware and or firmware would be well within the skill of one of skillin the art in light of this disclosure. In addition, those skilled inthe art will appreciate that the mechanisms of the subject matterdescribed herein are capable of being distributed as one or more programproducts in a variety of forms, and that an illustrative form of thesubject matter described herein applies regardless of the particulartype of signal bearing medium used to actually carry out thedistribution.

Instructions used to program logic to perform various disclosed aspectscan be stored within a memory in the system, such as dynamic randomaccess memory (DRAM), cache, flash memory, or other storage.Furthermore, the instructions can be distributed via a network or by wayof other computer readable media. Thus a machine-readable medium mayinclude any mechanism for storing or transmitting information in a formreadable by a machine (e.g., a computer), but is not limited to, floppydiskettes, optical disks, compact disc, read-only memory (CD-ROMs), andmagneto-optical disks, read-only memory (ROMs), random access memory(RAM), erasable programmable read-only memory (EPROM), electricallyerasable programmable read-only memory (EEPROM), magnetic or opticalcards, flash memory, or a tangible, machine-readable storage used in thetransmission of information over the Internet via electrical, optical,acoustical or other forms of propagated signals (e.g., carrier waves,infrared signals, digital signals, etc.). Accordingly, thenon-transitory computer-readable medium includes any type of tangiblemachine-readable medium suitable for storing or transmitting electronicinstructions or information in a form readable by a machine (e.g., acomputer).

As used in any aspect herein, the term “control circuit” may refer to,for example, hardwired circuitry, programmable circuitry (e.g., acomputer processor including one or more individual instructionprocessing cores, processing unit, processor, microcontroller,microcontroller unit, controller, digital signal processor (DSP),programmable logic device (PLD), programmable logic array (PLA), orfield programmable gate array (FPGA)), state machine circuitry, firmwarethat stores instructions executed by programmable circuitry, and anycombination thereof. The control circuit may, collectively orindividually, be embodied as circuitry that forms part of a largersystem, for example, an integrated circuit (IC), an application-specificintegrated circuit (ASIC), a system on-chip (SoC), desktop computers,laptop computers, tablet computers, servers, smart phones, etc.Accordingly, as used herein “control circuit” includes, but is notlimited to, electrical circuitry having at least one discrete electricalcircuit, electrical circuitry having at least one integrated circuit,electrical circuitry having at least one application specific integratedcircuit, electrical circuitry forming a general purpose computing deviceconfigured by a computer program (e.g., a general purpose computerconfigured by a computer program which at least partially carries outprocesses and/or devices described herein, or a microprocessorconfigured by a computer program which at least partially carries outprocesses and/or devices described herein), electrical circuitry forminga memory device (e.g., forms of random access memory), and/or electricalcircuitry forming a communications device (e.g., a modem, communicationsswitch, or optical-electrical equipment). Those having skill in the artwill recognize that the subject matter described herein may beimplemented in an analog or digital fashion or some combination thereof.

As used in any aspect herein, the term “logic” may refer to an app,software, firmware and/or circuitry configured to perform any of theaforementioned operations. Software may be embodied as a softwarepackage, code, instructions, instruction sets and/or data recorded onnon-transitory computer readable storage medium. Firmware may beembodied as code, instructions or instruction sets and/or data that arehard-coded (e.g., nonvolatile) in memory devices.

As used in any aspect herein, the terms “component,” “system,” “module”and the like can refer to a computer-related entity, either hardware, acombination of hardware and software, software, or software inexecution.

As used in any aspect herein, an “algorithm” refers to a self-consistentsequence of steps leading to a desired result, where a “step” refers toa manipulation of physical quantities and/or logic states which may,though need not necessarily, take the form of electrical or magneticsignals capable of being stored, transferred, combined, compared, andotherwise manipulated. It is common usage to refer to these signals asbits, values, elements, symbols, characters, terms, numbers, or thelike. These and similar terms may be associated with the appropriatephysical quantities and are merely convenient labels applied to thesequantities and/or states.

A network may include a packet switched network. The communicationdevices may be capable of communicating with each other using a selectedpacket switched network communications protocol. One examplecommunications protocol may include an Ethernet communications protocolwhich may be capable permitting communication using a TransmissionControl Protocol/Internet Protocol (TCP/IP). The Ethernet protocol maycomply or be compatible with the Ethernet standard published by theInstitute of Electrical and Electronics Engineers (IEEE) titled “IEEE802.3 Standard”, published in December, 2008 and/or later versions ofthis standard. Alternatively or additionally, the communication devicesmay be capable of communicating with each other using an X.25communications protocol. The X.25 communications protocol may comply orbe compatible with a standard promulgated by the InternationalTelecommunication Union-Telecommunication Standardization Sector(ITU-T). Alternatively or additionally, the communication devices may becapable of communicating with each other using a frame relaycommunications protocol. The frame relay communications protocol maycomply or be compatible with a standard promulgated by ConsultativeCommittee for International Telegraph and Telephone (CCITT) and/or theAmerican National Standards Institute (ANSI). Alternatively oradditionally, the transceivers may be capable of communicating with eachother using an Asynchronous Transfer Mode (ATM) communications protocol.The ATM communications protocol may comply or be compatible with an ATMstandard published by the ATM Forum titled “ATM-MPLS NetworkInterworking 2.0” published August 2001, and/or later versions of thisstandard. Of course, different and/or after-developedconnection-oriented network communication protocols are equallycontemplated herein.

Unless specifically stated otherwise as apparent from the foregoingdisclosure, it is appreciated that, throughout the foregoing disclosure,discussions using terms such as “processing,” “computing,”“calculating,” “determining,” “displaying,” or the like, refer to theaction and processes of a computer system, or similar electroniccomputing device, that manipulates and transforms data represented asphysical (electronic) quantities within the computer system's registersand memories into other data similarly represented as physicalquantities within the computer system memories or registers or othersuch information storage, transmission or display devices.

In various aspects, a control circuit as used herein is coupled to oneor more feedback systems that can be employed by the control circuit toperform predetermined functions such as, for example, issuing an alertwhen one or more predetermined conditions are met. In certain instances,the feedback systems may comprise one or more visual feedback systemssuch as display screens, backlights, and/or LEDs, for example. Incertain instances, the feedback systems may comprise one or more audiofeedback systems such as speakers and/or buzzers, for example. Incertain instances, the feedback systems may comprise one or more hapticfeedback systems, for example. In certain instances, the feedbacksystems may comprise combinations of visual, audio, and/or hapticfeedback systems, for example.

One or more components may be referred to herein as “configured to,”“configurable to,” “operable/operative to,” “adapted/adaptable,” “ableto,” “conformable/conformed to,” etc. Those skilled in the art willrecognize that “configured to” can generally encompass active-statecomponents and/or inactive-state components and/or standby-statecomponents, unless context requires otherwise.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” refers to the portion closest to the clinician andthe term “distal” refers to the portion located away from the clinician.It will be further appreciated that, for convenience and clarity,spatial terms such as “vertical”, “horizontal”, “up”, and “down” may beused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

Those skilled in the art will recognize that, in general, terms usedherein, and especially in the appended claims (e.g., bodies of theappended claims) are generally intended as “open” terms (e.g., the term“including” should be interpreted as “including but not limited to,” theterm “having” should be interpreted as “having at least,” the term“includes” should be interpreted as “includes but is not limited to,”etc.). It will be further understood by those within the art that if aspecific number of an introduced claim recitation is intended, such anintent will be explicitly recited in the claim, and in the absence ofsuch recitation no such intent is present. For example, as an aid tounderstanding, the following appended claims may contain usage of theintroductory phrases “at least one” and “one or more” to introduce claimrecitations. However, the use of such phrases should not be construed toimply that the introduction of a claim recitation by the indefinitearticles “a” or “an” limits any particular claim containing suchintroduced claim recitation to claims containing only one suchrecitation, even when the same claim includes the introductory phrases“one or more” or “at least one” and indefinite articles such as “a” or“an” (e.g., “a” and/or “an” should typically be interpreted to mean “atleast one” or “one or more”); the same holds true for the use ofdefinite articles used to introduce claim recitations.

In addition, even if a specific number of an introduced claim recitationis explicitly recited, those skilled in the art will recognize that suchrecitation should typically be interpreted to mean at least the recitednumber (e.g., the bare recitation of “two recitations,” without othermodifiers, typically means at least two recitations, or two or morerecitations). Furthermore, in those instances where a conventionanalogous to “at least one of A, B, and C, etc.” is used, in generalsuch a construction is intended in the sense one having skill in the artwould understand the convention (e.g., “a system having at least one ofA, B, and C” would include but not be limited to systems that have Aalone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). In those instances where aconvention analogous to “at least one of A, B, or C, etc.” is used, ingeneral such a construction is intended in the sense one having skill inthe art would understand the convention (e.g., “a system having at leastone of A, B, or C” would include but not be limited to systems that haveA alone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). It will be furtherunderstood by those within the art that typically a disjunctive wordand/or phrase presenting two or more alternative terms, whether in thedescription, claims, or drawings, should be understood to contemplatethe possibilities of including one of the terms, either of the terms, orboth terms unless context dictates otherwise. For example, the phrase “Aor B” will be typically understood to include the possibilities of “A”or “B” or “A and B.”

Wth respect to the appended claims, those skilled in the art willappreciate that recited operations therein may generally be performed inany order. Also, although various operational flow diagrams arepresented in a sequence(s), it should be understood that the variousoperations may be performed in other orders than those which areillustrated, or may be performed concurrently. Examples of suchalternate orderings may include overlapping, interleaved, interrupted,reordered, incremental, preparatory, supplemental, simultaneous,reverse, or other variant orderings, unless context dictates otherwise.Furthermore, terms like “responsive to,” “related to,” or otherpast-tense adjectives are generally not intended to exclude suchvariants, unless context dictates otherwise.

It is worthy to note that any reference to “one aspect,” “an aspect,”“an exemplification,” “one exemplification,” and the like means that aparticular feature, structure, or characteristic described in connectionwith the aspect is included in at least one aspect. Thus, appearances ofthe phrases “in one aspect,” “in an aspect,” “in an exemplification,”and “in one exemplification” in various places throughout thespecification are not necessarily all referring to the same aspect.Furthermore, the particular features, structures or characteristics maybe combined in any suitable manner in one or more aspects.

Any patent application, patent, non-patent publication, or otherdisclosure material referred to in this specification and/or listed inany Application Data Sheet is incorporated by reference herein. Anymaterial, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

In summary, numerous benefits have been described which result fromemploying the concepts described herein. The foregoing description ofthe one or more forms has been presented for purposes of illustrationand description. It is not intended to be exhaustive or limiting to theprecise form disclosed. Modifications or variations are possible inlight of the above teachings. The one or more forms were chosen anddescribed in order to illustrate principles and practical application tothereby enable one of ordinary skill in the art to utilize the variousforms and with various modifications as are suited to the particular usecontemplated. It is intended that the claims submitted herewith definethe overall scope.

Many of the surgical instrument systems described herein are motivatedby an electric motor; however, the surgical instrument systems describedherein can be motivated in any suitable manner. In various instances,the surgical instrument systems described herein can be motivated by amanually-operated trigger, for example. In certain instances, the motorsdisclosed herein may comprise a portion or portions of a roboticallycontrolled system. Moreover, any of the end effectors and/or toolassemblies disclosed herein can be utilized with a robotic surgicalinstrument system. U.S. patent application Ser. No. 13/118,241, entitledSURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example, disclosesseveral examples of a robotic surgical instrument system in greaterdetail.

The entire disclosures of:

-   U.S. Pat. No. 5,403,312, entitled ELECTROSURGICAL HEMOSTATIC DEVICE,    which issued on Apr. 4, 1995;-   U.S. Pat. No. 7,000,818, entitled SURGICAL STAPLING INSTRUMENT    HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, which issued on    Feb. 21, 2006;-   U.S. Pat. No. 7,422,139, entitled MOTOR-DRIVEN SURGICAL CUTTING AND    FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, which issued on    Sep. 9, 2008;-   U.S. Pat. No. 7,464,849, entitled ELECTRO-MECHANICAL SURGICAL    INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS, which    issued on Dec. 16, 2008;-   U.S. Pat. No. 7,670,334, entitled SURGICAL INSTRUMENT HAVING AN    ARTICULATING END EFFECTOR, which issued on Mar. 2, 2010;-   U.S. Pat. No. 7,753,245, entitled SURGICAL STAPLING INSTRUMENTS,    which issued on Jul. 13, 2010;-   U.S. Pat. No. 8,393,514, entitled SELECTIVELY ORIENTABLE IMPLANTABLE    FASTENER CARTRIDGE, which issued on Mar. 12, 2013;-   U.S. patent application Ser. No. 11/343,803, entitled SURGICAL    INSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Pat. No.    7,845,537;-   U.S. patent application Ser. No. 12/031,573, entitled SURGICAL    CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES, filed Feb.    14, 2008;-   U.S. patent application Ser. No. 12/031,873, entitled END EFFECTORS    FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, filed Feb. 15, 2008,    now U.S. Pat. No. 7,980,443;-   U.S. patent application Ser. No. 12/235,782, entitled MOTOR-DRIVEN    SURGICAL CUTTING INSTRUMENT, now U.S. Pat. No. 8,210,411;-   U.S. patent application Ser. No. 12/235,972, entitled MOTORIZED    SURGICAL INSTRUMENT, now U.S. Pat. No. 9,050,083.-   U.S. patent application Ser. No. 12/249,117, entitled POWERED    SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE    FIRING SYSTEM, now U.S. Pat. No. 8,608,045;-   U.S. patent application Ser. No. 12/647,100, entitled MOTOR-DRIVEN    SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL    CONTROL ASSEMBLY, filed Dec. 24, 2009, now U.S. Pat. No. 8,220,688;-   U.S. patent application Ser. No. 12/893,461, entitled STAPLE    CARTRIDGE, filed Sep. 29, 2012, now U.S. Pat. No. 8,733,613;-   U.S. patent application Ser. No. 13/036,647, entitled SURGICAL    STAPLING INSTRUMENT, filed Feb. 28, 2011, now U.S. Pat. No.    8,561,870;-   U.S. patent application Ser. No. 13/118,241, entitled SURGICAL    STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS,    now U.S. Pat. No. 9,072,535;-   U.S. patent application Ser. No. 13/524,049, entitled ARTICULATABLE    SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, filed on Jun. 15,    2012, now U.S. Pat. No. 9,101,358;-   U.S. patent application Ser. No. 13/800,025, entitled STAPLE    CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013,    now U.S. Pat. No. 9,345,481;-   U.S. patent application Ser. No. 13/800,067, entitled STAPLE    CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013,    now U.S. Patent Application Publication No. 2014/0263552;-   U.S. Patent Application Publication No. 2007/0175955, entitled    SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER    LOCKING MECHANISM, filed Jan. 31, 2006; and-   U.S. Patent Application Publication No. 2010/0264194, entitled    SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR,    filed Apr. 22, 2010, now U.S. Pat. No. 8,308,040, are hereby    incorporated by reference herein.

Although various devices have been described herein in connection withcertain embodiments, modifications and variations to those embodimentsmay be implemented. Particular features, structures, or characteristicsmay be combined in any suitable manner in one or more embodiments. Thus,the particular features, structures, or characteristics illustrated ordescribed in connection with one embodiment may be combined in whole orin part, with the features, structures or characteristics of one oremore other embodiments without limitation. Also, where materials aredisclosed for certain components, other materials may be used.Furthermore, according to various embodiments, a single component may bereplaced by multiple components, and multiple components may be replacedby a single component, to perform a given function or functions. Theforegoing description and following claims are intended to cover allsuch modification and variations.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, a device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the stepsincluding, but not limited to, the disassembly of the device, followedby cleaning or replacement of particular pieces of the device, andsubsequent reassembly of the device. In particular, a reconditioningfacility and/or surgical team can disassemble a device and, aftercleaning and/or replacing particular parts of the device, the device canbe reassembled for subsequent use. Those skilled in the art willappreciate that reconditioning of a device can utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

The devices disclosed herein may be processed before surgery. First, anew or used instrument may be obtained and, when necessary, cleaned. Theinstrument may then be sterilized. In one sterilization technique, theinstrument is placed in a closed and sealed container, such as a plasticor TYVEK bag. The container and instrument may then be placed in a fieldof radiation that can penetrate the container, such as gamma radiation,x-rays, and/or high-energy electrons. The radiation may kill bacteria onthe instrument and in the container. The sterilized instrument may thenbe stored in the sterile container. The sealed container may keep theinstrument sterile until it is opened in a medical facility. A devicemay also be sterilized using any other technique known in the art,including but not limited to beta radiation, gamma radiation, ethyleneoxide, plasma peroxide, and/or steam.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples.

What is claimed is:
 1. A surgical instrument, comprising: a surgical endeffector comprising an end effector frame assembly; and a proximal shaftsegment defining a shaft axis, wherein said proximal shaft segment isattached to said end effector frame assembly by an articulation systemto facilitate articulation of said end effector frame assembly relativeto said proximal shaft segment about an articulation axis that istransverse to said shaft axis, wherein said articulation systemcomprises: a first link comprising: a first link proximal end pivotallycoupled to said proximal shaft segment; and a first link distal end, andwherein said articulation system further comprises: a second link,comprising: a second link proximal end pivotally coupled to said firstlink distal end; and a second link distal end pivotally coupled to saidend effector frame assembly, and wherein said articulation systemfurther comprises an axially movable articulation actuator operablyinterfacing with said first link at a location between said first linkproximal end and said first link distal end to apply articulationmotions thereto.
 2. The surgical instrument of claim 1, wherein saidfirst link comprises: a right proximal link, comprising: a rightproximal link proximal end pivotally coupled to said proximal shaftsegment on a right side of said shaft axis; and a right proximal linkdistal end, and wherein said first link further comprises: a leftproximal link, comprising: a left proximal link proximal end pivotallycoupled to said proximal shaft segment on a left side of said shaftaxis; and a left proximal link distal end, wherein said second linkproximal end is pivotally coupled to said right proximal link distal endand said left proximal link distal end, wherein said axially movablearticulation actuator operably interfaces with said right proximal linkat a right pivot location on said right proximal link between said rightproximal link proximal end and said right proximal link distal end, andwherein said axially movable articulation actuator operably interfaceswith said left proximal link at a left pivot location on said leftproximal link between said left proximal link proximal end and said leftproximal link distal end.
 3. The surgical instrument of claim 2, whereinsaid axially movably articulation actuator pivotally interfaces withsaid right proximal link at said right pivot location, and wherein saidaxially movable articulation actuator pivotally interfaces with saidleft proximal link at said left pivot location.
 4. The surgicalinstrument of claim 2, wherein said second link proximal end ispivotally coupled to said right proximal link distal end and said leftproximal link distal end.
 5. The surgical instrument of claim 4, whereinsaid second link proximal end spans transversely across said shaft axisand is pivotally coupled to said right proximal link distal end and saidleft proximal link distal end.
 6. The surgical instrument of claim 5,wherein said second link proximal end is centrally disposed between saidright proximal link distal end and said left proximal link distal end.7. The surgical instrument of claim 2, further comprising a drive memberextending between said right proximal link and said left proximal linkto apply a drive motion to said surgical end effector.
 8. The surgicalinstrument of claim 7, wherein said drive motion comprises a rotarydrive motion.
 9. The surgical instrument of claim 7, wherein said drivemotion comprises an axial drive motion.
 10. The surgical instrument ofclaim 7, wherein said drive motion comprises: a first rotary drivemotion; and a second axial drive motion.
 11. The surgical instrument ofclaim 10, wherein said drive member comprises a flexible shaft assembly.12. The surgical instrument of claim 1, wherein said surgical endeffector further comprises: a first jaw pivotally supported on said endeffector frame assembly; and a second jaw pivotally supported relativeto said first jaw, wherein said first jaw and said second jaw arepivotable relative to each other between an open position and a closedposition upon axial control motions applied to one of said first jaw andsaid second jaw.
 13. The surgical instrument of claim 1, wherein saidsecond link is U-shaped.
 14. The surgical instrument of claim 2, whereinsaid second link distal end comprises: a left second link arm coupled tosaid second link proximal end; and a right second link arm coupled tosaid second link proximal end, wherein said left second link arm isspaced from said right second link arm, and wherein said left secondlink arm and said right second link arm are pivotally coupled to saidend effector frame assembly by an end effector link pin.
 15. A surgicalinstrument, comprising: a surgical end effector comprising: an endeffector frame assembly; a first jaw pivotally coupled to said endeffector frame assembly; and a second jaw pivotally coupled to saidfirst jaw, wherein said first jaw and said second jaw are pivotallymovable between an open position and a closed position upon applicationof axial control motions to said second jaw, and wherein said surgicalinstrument further comprises: a proximal shaft segment defining a shaftaxis, wherein said proximal shaft segment is attached to said endeffector frame assembly by an articulation system, wherein saidarticulation system is configured to facilitate articulation of said endeffector frame assembly relative to said proximal shaft segment about anarticulation axis that is transverse to said shaft axis, wherein saidarticulation system comprises: a first link comprising: a first linkproximal end pivotally coupled to said proximal shaft segment; and afirst link distal end, and wherein said articulation system furthercomprises: a second link, comprising: a second link proximal endpivotally coupled to said first link distal end; and a second linkdistal end pivotally coupled to said end effector frame assembly, andwherein said articulation system further comprises an axially movablearticulation actuator operably interfacing with said first link at alocation between said first link proximal end and said first link distalend to apply articulation motions thereto, and wherein said surgicalinstrument further comprises: a drive member extending between saidright proximal link and said left proximal link, wherein said drivemember is coupled to said second jaw to apply said axial control motionsthereto.
 16. The surgical instrument of claim 15, wherein said secondlink is U-shaped.
 17. The surgical instrument of claim 15, wherein saidproximal shaft segment comprises: a proximal outer shaft tube definingan outer diameter; and a proximal retainer member protruding distallyfrom a distal end of said proximal outer shaft tube, wherein saidproximal retainer member is pivotally coupled to said end effector frameassembly to facilitate articulation of said end effector frame assemblyrelative to said proximal retainer member about said articulation axis,and wherein said first link proximal end is pivotally coupled to saidproximal retainer member.
 18. The surgical instrument of claim 17,wherein said first link comprises: a right proximal link, comprising: aright proximal link proximal end pivotally coupled to said proximalretainer member on a right side of said shaft axis; and a right proximallink distal end, and wherein said first link further comprises: a leftproximal link, comprising: a left proximal link proximal end pivotallycoupled to said proximal retainer member on a left side of said shaftaxis; and a left proximal link distal end, wherein said second linkproximal end is pivotally coupled to said right proximal link distal endand said left proximal link distal end, wherein said axially movablearticulation actuator operably interfaces with said right proximal linkat a right pivot location on said right proximal link between said rightproximal link proximal end and said right proximal link distal end, andwherein said axially movable articulation actuator operably interfaceswith said left proximal link at a left pivot location on said left linkbetween said left proximal link proximal end and said left proximal linkdistal end.
 19. The surgical instrument of claim 18, wherein said rightproximal link and said left proximal link do not extend outward beyondsaid outer diameter of said proximal outer shaft tube.
 20. The surgicalinstrument of claim 19, wherein said right proximal link defines a rightradiused outer surface located between said right proximal link proximalend and said right proximal link distal end, and wherein said leftproximal link defines a left radiused outer surface located between saidleft proximal link proximal end and said left proximal link distal end.